Reduced use of emergency care and hospitalization in patients with post-stroke cognitive impairment treated with traditional Chinese medicine

C. C. Shih, C. C. Yeh, J. L. Yang, H. L. Lane, C. J. Huang, J. G. Lin, T. L. Chen, C. C. Liao

Research output: Contribution to journalArticle

Abstract

Background: The effect of traditional Chinese medicine (TCM) on the outcomes of dementia remains unclear. Our purpose is to compare the use of emergency care and hospitalization in patients with post-stroke cognitive impairment (PSCI) with or without treatment of TCM. Methods: In a stroke cohort of 67 521 patients with PSCI aged over 40 years obtained from the 23 million people in Taiwan's national health insurance between 2000 and 2007, we identified 6661 newly diagnosed PSCI patients who were treated with TCM and 6661 propensity score-matched PSCI patients who were not treated with TCM. Under the control of immortal time bias, we calculated the adjusted rate ratios (RRs) and 95% CIs of the 1-year use of emergency care and hospitalization associated with TCM. Results: Themeans of the emergency caremedical visits (0.4060.98 vs. 0.4761.01, P=0.0001) and hospitalization (0.7261.29 vs. 0.9661.49, P<0.0001) were lower in the PSCI patients treated with TCM than in those without the TCMtreatment. The RRs of emergency care and hospitalization associated with TCM were 0.87 (95% CI=0.82-0.92) and 0.81 (95% CI=0.78-0.84), respectively. The PSCI patients treated with a combination of acupuncture and herbalmedicine had the lowest risk of emergency care visits and hospitalization. Conclusions: Our study raises the possibility that TCM use was associated with reduced use of emergency care and hospitalization after PSCI. However, further randomized clinical trials are needed to provide solid evidence of this benefit and identify the underlying mechanism.

Original languageEnglish
Pages (from-to)437-442
Number of pages6
JournalQJM
Volume112
Issue number6
DOIs
Publication statusPublished - Jun 1 2019

Fingerprint

Chinese Traditional Medicine
Emergency Medical Services
Hospitalization
Stroke
Propensity Score
Cognitive Dysfunction
National Health Programs
Acupuncture
Taiwan
Dementia
Emergencies
Randomized Controlled Trials

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Reduced use of emergency care and hospitalization in patients with post-stroke cognitive impairment treated with traditional Chinese medicine. / Shih, C. C.; Yeh, C. C.; Yang, J. L.; Lane, H. L.; Huang, C. J.; Lin, J. G.; Chen, T. L.; Liao, C. C.

In: QJM, Vol. 112, No. 6, 01.06.2019, p. 437-442.

Research output: Contribution to journalArticle

Shih, C. C. ; Yeh, C. C. ; Yang, J. L. ; Lane, H. L. ; Huang, C. J. ; Lin, J. G. ; Chen, T. L. ; Liao, C. C. / Reduced use of emergency care and hospitalization in patients with post-stroke cognitive impairment treated with traditional Chinese medicine. In: QJM. 2019 ; Vol. 112, No. 6. pp. 437-442.
@article{cf5abbc70b92450a872e7318f6c426bf,
title = "Reduced use of emergency care and hospitalization in patients with post-stroke cognitive impairment treated with traditional Chinese medicine",
abstract = "Background: The effect of traditional Chinese medicine (TCM) on the outcomes of dementia remains unclear. Our purpose is to compare the use of emergency care and hospitalization in patients with post-stroke cognitive impairment (PSCI) with or without treatment of TCM. Methods: In a stroke cohort of 67 521 patients with PSCI aged over 40 years obtained from the 23 million people in Taiwan's national health insurance between 2000 and 2007, we identified 6661 newly diagnosed PSCI patients who were treated with TCM and 6661 propensity score-matched PSCI patients who were not treated with TCM. Under the control of immortal time bias, we calculated the adjusted rate ratios (RRs) and 95{\%} CIs of the 1-year use of emergency care and hospitalization associated with TCM. Results: Themeans of the emergency caremedical visits (0.4060.98 vs. 0.4761.01, P=0.0001) and hospitalization (0.7261.29 vs. 0.9661.49, P<0.0001) were lower in the PSCI patients treated with TCM than in those without the TCMtreatment. The RRs of emergency care and hospitalization associated with TCM were 0.87 (95{\%} CI=0.82-0.92) and 0.81 (95{\%} CI=0.78-0.84), respectively. The PSCI patients treated with a combination of acupuncture and herbalmedicine had the lowest risk of emergency care visits and hospitalization. Conclusions: Our study raises the possibility that TCM use was associated with reduced use of emergency care and hospitalization after PSCI. However, further randomized clinical trials are needed to provide solid evidence of this benefit and identify the underlying mechanism.",
author = "Shih, {C. C.} and Yeh, {C. C.} and Yang, {J. L.} and Lane, {H. L.} and Huang, {C. J.} and Lin, {J. G.} and Chen, {T. L.} and Liao, {C. C.}",
year = "2019",
month = "6",
day = "1",
doi = "10.1093/qjmed/hcz044",
language = "English",
volume = "112",
pages = "437--442",
journal = "QJM - Monthly Journal of the Association of Physicians",
issn = "1460-2725",
publisher = "Oxford University Press",
number = "6",

}

TY - JOUR

T1 - Reduced use of emergency care and hospitalization in patients with post-stroke cognitive impairment treated with traditional Chinese medicine

AU - Shih, C. C.

AU - Yeh, C. C.

AU - Yang, J. L.

AU - Lane, H. L.

AU - Huang, C. J.

AU - Lin, J. G.

AU - Chen, T. L.

AU - Liao, C. C.

PY - 2019/6/1

Y1 - 2019/6/1

N2 - Background: The effect of traditional Chinese medicine (TCM) on the outcomes of dementia remains unclear. Our purpose is to compare the use of emergency care and hospitalization in patients with post-stroke cognitive impairment (PSCI) with or without treatment of TCM. Methods: In a stroke cohort of 67 521 patients with PSCI aged over 40 years obtained from the 23 million people in Taiwan's national health insurance between 2000 and 2007, we identified 6661 newly diagnosed PSCI patients who were treated with TCM and 6661 propensity score-matched PSCI patients who were not treated with TCM. Under the control of immortal time bias, we calculated the adjusted rate ratios (RRs) and 95% CIs of the 1-year use of emergency care and hospitalization associated with TCM. Results: Themeans of the emergency caremedical visits (0.4060.98 vs. 0.4761.01, P=0.0001) and hospitalization (0.7261.29 vs. 0.9661.49, P<0.0001) were lower in the PSCI patients treated with TCM than in those without the TCMtreatment. The RRs of emergency care and hospitalization associated with TCM were 0.87 (95% CI=0.82-0.92) and 0.81 (95% CI=0.78-0.84), respectively. The PSCI patients treated with a combination of acupuncture and herbalmedicine had the lowest risk of emergency care visits and hospitalization. Conclusions: Our study raises the possibility that TCM use was associated with reduced use of emergency care and hospitalization after PSCI. However, further randomized clinical trials are needed to provide solid evidence of this benefit and identify the underlying mechanism.

AB - Background: The effect of traditional Chinese medicine (TCM) on the outcomes of dementia remains unclear. Our purpose is to compare the use of emergency care and hospitalization in patients with post-stroke cognitive impairment (PSCI) with or without treatment of TCM. Methods: In a stroke cohort of 67 521 patients with PSCI aged over 40 years obtained from the 23 million people in Taiwan's national health insurance between 2000 and 2007, we identified 6661 newly diagnosed PSCI patients who were treated with TCM and 6661 propensity score-matched PSCI patients who were not treated with TCM. Under the control of immortal time bias, we calculated the adjusted rate ratios (RRs) and 95% CIs of the 1-year use of emergency care and hospitalization associated with TCM. Results: Themeans of the emergency caremedical visits (0.4060.98 vs. 0.4761.01, P=0.0001) and hospitalization (0.7261.29 vs. 0.9661.49, P<0.0001) were lower in the PSCI patients treated with TCM than in those without the TCMtreatment. The RRs of emergency care and hospitalization associated with TCM were 0.87 (95% CI=0.82-0.92) and 0.81 (95% CI=0.78-0.84), respectively. The PSCI patients treated with a combination of acupuncture and herbalmedicine had the lowest risk of emergency care visits and hospitalization. Conclusions: Our study raises the possibility that TCM use was associated with reduced use of emergency care and hospitalization after PSCI. However, further randomized clinical trials are needed to provide solid evidence of this benefit and identify the underlying mechanism.

UR - http://www.scopus.com/inward/record.url?scp=85067116728&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85067116728&partnerID=8YFLogxK

U2 - 10.1093/qjmed/hcz044

DO - 10.1093/qjmed/hcz044

M3 - Article

C2 - 30778546

AN - SCOPUS:85067116728

VL - 112

SP - 437

EP - 442

JO - QJM - Monthly Journal of the Association of Physicians

JF - QJM - Monthly Journal of the Association of Physicians

SN - 1460-2725

IS - 6

ER -