Evaluation of bleeding-related adverse events following acupuncture treatment in patients on anticoagulant or antiplatelet drugs: A prospective observational study

Objective: To evaluate the risk of bleeding-related adverse events after acupuncture treatment in patients receiving anticoagulant or antiplatelet drugs. Design and setting: : A total of 428 inpatients who received acupuncture treatment underwent two assessments for bleeding-related adverse events, such as micro-bleeding, hematoma, and ecchymosis: 1) immediately after acupuncture treatment on the first day and 2) before acupuncture treatment on the following day. Additional analyses were performed using the number of acupuncture needles as independent variables. Multivariable analysis using factors likely related to bleeding and subgroup analysis according to regions of needle insertion were also performed. Results: A total of 169 patients receiving anticoagulant or antiplatelet drugs (exposure group) and 259 patients not receiving either drug (non-exposure group) were studied. Sixty-five (38.5%) patients in the exposure group and 115 (44.4%) patients in the non-exposure group had bleeding-related mild adverse events. There was no difference in the risk of bleeding-related adverse events between the two groups per sessions (relative risk (RR) 0.87, 95% confidence interval (CI), 0.69-1.10) and per needles (RR 0.89, 95% CI 0.70-1.13). In multivariable analysis, thickness of needle only increased risk of bleeding. Subgroup analysis showed that taking these drugs did not increase the risk of bleeding in any of the regions. Conclusion: Our findings suggest that anticoagulant and antiplatelet drugs do not increase the incidence of bleeding-related adverse events after acupuncture treatment.