Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Department of Infectious Diseases, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
J Korean Med Sci. 2018 May 9;33(24):e164. doi: 10.3346/jkms.2018.33.e164. eCollection 2018 Jun 11.
We investigated the clinical progress and bacteriological characteristics of infectious adverse events (AEs) following acupuncture and compared patient characteristics between serious and non-serious outcome groups.
A retrospective observational study was conducted in 1,174 patients with infectious complications associated with acupuncture at the emergency department (ED) in a tertiary hospital in Korea between 2010 and 2014. Serious outcome was defined as development of septic shock, admission to intensive care unit (ICU) or attaining permanent morbidity.
Forty-eight patients had certain causality and cellulitis, necrotizing fasciitis and osteomyelitis were common in order. Among them, 9 patients (18.8%) were categorized into serious outcome group, and they showed devastating outcomes such as septic shock (n = 2), ICU admission (n = 4), and permanent sequelae (n = 5). The serious group had delayed admission to the ED after acupuncture (30.0 [4.0-55.0] vs. 3.0 [1.0-10.0] days, = 0.023). Methicillin-sensitive was the most frequently identified microorganism. The patients in the serious group required longer treatment duration (139.0 [49.0-183.5] vs. 14.0 [7.0-34.0] days, < 0.001) as well as more operation with local (44.4% vs. 10.3%, = 0.031) or general anaesthesia (33.3% vs. 2.6%, = 0.017).
The infectious AEs after acupuncture may cause serious outcomes. Patients and primary physicians should be aware of the risk of infectious complications and make efforts to prevent them.
本研究旨在调查针灸治疗后感染不良事件（AE）的临床进展和细菌学特征，并比较严重和非严重结局患者的特征。
本研究为回顾性观察研究，纳入 2010 年至 2014 年期间在韩国一家三级医院急诊科因针灸感染并发症就诊的 1174 例患者。严重结局定义为脓毒症休克、入住重症监护病房（ICU）或出现永久性残疾。
48 例患者具有明确的因果关系，蜂窝织炎、坏死性筋膜炎和骨髓炎是最常见的类型。其中，9 例（18.8%）患者归入严重结局组，表现为脓毒症休克（n=2）、入住 ICU（n=4）和永久性后遗症（n=5）等严重后果。严重组患者在针灸后就诊至急诊科的时间延迟（30.0[4.0-55.0]天 vs. 3.0[1.0-10.0]天， = 0.023）。最常鉴定出的微生物是耐甲氧西林的 。严重组患者的治疗时间更长（139.0[49.0-183.5]天 vs. 14.0[7.0-34.0]天， < 0.001），需要更多的局部（44.4% vs. 10.3%， = 0.031）或全身麻醉（33.3% vs. 2.6%， = 0.017）手术。
针灸后感染性 AE 可能导致严重结局。患者和初级医师应意识到感染并发症的风险，并努力预防。
