Evaluation of Bleeding-Related Adverse Events Following Acupuncture Treatment in Patients on Anticoagulant or Antiplatelet Drugs

摘要

Background: Caution needs to be exercised when acupuncture is administered in patients with coagulopathy or on anticoagulant or antiplatelet drugs, which may increase the risk of bleeding after surgery or trauma. Previous retrospectivecase-control and retrospective chart review studies have reported safety of acupuncture in patients taking anticoagulants,but no prospective study has been conducted to dateObjective: To evaluate the risk of bleeding-related adverse events following acupuncture treatment in patients receivinganticoagulant or antiplatelet drugs.Design and setting: A total of 428 inpatients who received acupuncture treatment underwent two assessments for bleedingrelated adverse events: 1) immediately after acupuncture treatment on the first day and 2) before acupuncture treatmenton the following day. Primary outcome was relative risk of bleeding related adverse events in the exposure group (receivinganticoagulant or antiplatelet drugs) compared to the risk of the adverse events in the non-exposure group (not receivingeither drug). Additional analyses were performed using the number and diameter of the acupuncture needles as independent variables.Results: A total of 169 patients in exposure group and 259 patients in non-exposure group were studied. Sixty-six (39.1%)patients in the exposure group and 115 (44.4%) patients in the non-exposure group had bleeding-related mild adverseevents. There was no difference in the risk of bleeding-related adverse events between the two groups (relativerisk Z 0.88, 95% confidence interval, 0.70e1.11). The relative risk associated with the number of acupuncture needles was0.91 (95% confidence interval 0.71e1.16), and the needle diameter did not affect the incidence of bleeding-related adverseevents.Discussion and conclusion: Our findings suggest that anticoagulant and antiplatelet drugs do not increase the incidence ofbleeding-related adverse events after acupuncture treatment.