Abstract
This study aims to examine the long-term effect of adjuvant treatment in Korean Medicine (KM) clinics in ischemic stroke patients, using a national sample cohort from the National Health Insurance Service in Korea between 2010 and 2013. The National Health Insurance Service – National Sample Cohort database from 2002 to 2013 was used in this study. Ischemic stroke patients were defined and covariates were included to account for socioeconomic variables, comorbidities and disease severity. Propensity score matching was applied. Cox proportional hazards modeling and Kaplan-Meier analysis were applied to determine the differences between KM and non-KM treated groups. The results shows that KM-treated group had a higher probability of survival than non-KM group patients. No significant difference was observed between the risk of readmission between the treated and non-treated patients. Kaplan-Meier analysis showed a weak effect of KM treatments in the patients with 8 to 28 days of hospital stay for a lower risk of recurrence than in non-treated patients. In conclusion, KM treatment of mild to moderate ischemic stroke patients has a mild effect on the survival probability of stroke. Its effect for improving long-term recurrence need to be explored in the future studies.
Highlights
Stroke is the second leading cause of death worldwide[1,2]; stroke is the leading cause of death from a single organ disease in Korea[3]
We investigated the risk of long-term mortality and the hospital readmission rate in mildly to moderately severe ischemic stroke patients treated with Korean Medicine (KM) compared to those who did not receive KM treatments based on the National Health Insurance Service - National Sample Cohort (NHIS-NSC)
The final population of mild to moderately severe ischemic stroke patients from 2010 and 2011 (n = 448) was divided into two groups including those with (n = 108) or without (n = 340) adjuvant treatment from KM clinics according to the claims data
Summary
Stroke is the second leading cause of death worldwide[1,2]; stroke is the leading cause of death from a single organ disease in Korea[3]. The medical effectiveness of East Asian Medicine, including acupuncture and herbal medicines, has become a subject of study in the past few decades, experimental and clinical data have shown limited results when evaluating the efficacy of East Asian Medicine for post-stroke treatment and management[9,10,11,12]. KM, including acupuncture and herbal medicines, is still widely used among ischemic stroke patients as an adjuvant therapy for the prevention of secondary stroke and mortality[7]. We investigated the risk of long-term mortality and the hospital readmission rate in mildly to moderately severe ischemic stroke patients treated with KM compared to those who did not receive KM treatments based on the National Health Insurance Service - National Sample Cohort (NHIS-NSC)
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