253: Use of Acupuncture in Traumatic Amputees: a Population Based Historical Cohort Study in South Korea

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Chronic posttraumatic pain, Epidemiology, Pain in Special Populations , Treatment/management

Background and Aims: Patients with traumatic limb amputation often require long-term rehabilitation and health service access. Burden of substantial morbidity and physical inactivity due to disability is likely to increase risk of mortality. Few information from population-based studies is available, however, highlighting evidence gap on prognosis and use of healthcare resources after traumatic limb amputation. This study aimed to estimate five-year mortality, use of healthcare services specifically focused on acupuncture, visit to physician due to pain, and opioid prescription in adults after traumatic limb amputation in South Korea.

Methods: The population-representative National Health Insurance Service System in South Korea was used. Adults who had diagnosis of traumatic limb amputation or crushed limb which resulted in amputation in 2018 or 2019 and those survived at least 3 months after injury were eligible and followed up 5 years. Use of healthcare resources including acupuncture, physician visit due to pain, and opioid prescription was ascertained. We performed descriptive summary on clinical and sociodemographic characteristics and regression analysis for association between use of acupuncture with all-cause mortality, physician visit due to pain and chronic opioid use.

Results: A 29,752 newly diagnosed traumatic amputees were included, with 1,997 all-cause deaths. The crude mortality rate was 13.1 per 1,000 person-years (95% CI 12.6 to 13.8). A 34% and 3% of patients used acupuncture service and prescribed opioids after 3 months postinjury, respectively. The crude incidence rate of physician visit due to pain was 3.8 per 1 person-year. Use of acupuncture was associated with lower all-cause mortality (aHR 0.78, 95% CI 0.71 to 0.86), increased visit to physician due to pain (aIRR 2.3, 95% CI 2.2 to 2.4) and opioid use (aOR 1.35, 95%CI 1.16 to 1.59).

Conclusions: This study shows population-based estimates of all-cause mortality rates and patterns of use of selected healthcare resources with up to 5 years after traumatic limb amputation. Mixed benefits on all-cause mortality and increased use of healthcare resources in acupuncture user should be interpreted with caution due to potential risk of selection bias and residual confounding. Further investigation on healthcare-seeking pattern and its determinants is warranted to design optimal provision of long-term care for the patients after traumatic limb amputation who often suffer from chronic pain and disability.

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Presenting Author: KUNHYUNG KIM
Submitting Author: KUN HYUNG KIM

Senior Author: KUNHYUNG KIM

IASP 2026 Global Year theme of Neuropathic Pain: Yes

• Hyun Min Cho - Department of Trauma Surgery and Critical Care, Jeju Province Trauma Center, Jeju Halla General Hospital, Jeju Special Self-Governing Province, South Korea
• Seon Hee Kim - Department of Trauma and Surgical Critical Care, School of Medicine, Pusan National University, Busan, South Korea
• Na Hyeon Lee - Department of Thoracic and Cardiovascular Surgery, National Trauma Center, National Medical Center, Seoul, South Korea
• Youngwoong Kim - Department of Thoracic and Cardiovascular Surgery, National Trauma Center, National Medical Center, Seoul, South Korea
• Yu Kyung Shin - Clinical Research Center for Korean Medicine, Pusan National University Korean Medicine Hospital, Yangsan, South Korea