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Open AccessArticle

Incidence of Cellulitis Following Acupuncture Treatments in Taiwan

1
Department of Chinese Medicine, Taipei City Hospital, Renai Branch, Taipei 106, Taiwan
2
Institute of Public Health, National Yang-Ming University, Taipei 112, Taiwan
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Division of Urology, Department of Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan 330, Taiwan
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Department of Medicine, National Yang-Ming University, Taipei 112, Taiwan
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Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 114, Taiwan
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Department of Chinese Medicine, China Medical University, Taichung 404, Taiwan
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Cancer Medicine Center of Buddhist Hualien Tzu Chi Hospital, Tzu Chi University, Hualien 970, Taiwan
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Department of Pathology and Graduate Institute of Pathology and Parasitology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
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Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan
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Graduate Institute of Clinical Medical Science, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Int. J. Environ. Res. Public Health 2019, 16(20), 3831; https://doi.org/10.3390/ijerph16203831
Received: 19 August 2019 / Revised: 4 October 2019 / Accepted: 7 October 2019 / Published: 11 October 2019
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Background: Cellulitis is a complication of acupuncture, but the risk factors and annualized incidence remain unclear. Objective: This study analyzed the incidence and risk factors of cellulitis related to acupuncture in a cohort of one million participants derived from Taiwan’s Longitudinal Health Insurance Database. Methods: We tracked this cohort between 1997 and 2012 and recorded all outpatient medical information including diagnosis and treatment. Patients were categorized according to age, gender, comorbidities, residential area, and number of acupuncture treatments. We compared the incidence and risk of cellulitis between different demographics and comorbidities by logistic regression analysis and adjusted odds ratio (aOR) with a 95% confidence interval (95% CI). Results: We included 407,802 patients and 6,207,378 acupuncture treatments. The incidence of cellulitis after acupuncture was 64.4 per 100,000 courses of acupuncture treatment. The most common sites of cellulitis after acupuncture were the legs, feet, and face. Comorbidity was associated with post-acupuncture cellulitis; a multivariate logistic regression analysis showed that chronic kidney disease (aOR, 1.71; 95% CI, 1.55–1.88), rheumatoid arthritis (aOR, 1.86; 95% CI, 1.21–3.60), liver cirrhosis (aOR, 1.23; 95% CI, 1.15–1.32), diabetes mellitus (aOR, 1.69; 95% CI, 1.57–1.82), stroke (aOR, 1.44; 95% CI, 1.31–1.58), varicose veins (aOR, 2.38; 95% CI, 2.17–2.84), or heart failure (aOR, 1.81; 95% CI, 1.65–1.98) significantly increased cellulitis. Repeated exposure to acupuncture treatment was associated with an increased risk of cellulitis. Conclusions: A variety of chronic diseases may increase the risk of cellulitis after acupuncture. Physicians asked about past medical history before acupuncture might help to reduce cellulitis. View Full-Text
Keywords: acupuncture; cellulitis; risk factors; varicose veins; liver cirrhosis; heart failure acupuncture; cellulitis; risk factors; varicose veins; liver cirrhosis; heart failure
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MDPI and ACS Style

Lin, S.-K.; Liu, J.-M.; Wang, P.-H.; Hung, S.-P.; Hsu, R.-J.; Chuang, H.-C.; Lin, P.-H. Incidence of Cellulitis Following Acupuncture Treatments in Taiwan. Int. J. Environ. Res. Public Health 2019, 16, 3831.

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