A nationwide retrospective cohort study of the association between acupuncture exposure and clinical outcomes of idiopathic Parkinson's disease using health insurance claim data in South Korea.

Background: Idiopathic Parkinson's disease (IPD) has been associated with increased global mortality. While acupuncture has been reported to slow IPD progression, its effect on mortality remains unclear. This study investigated the association between acupuncture exposure and mortality, causes of death, and prognosis in patients with IPD. Methods: Using customized cohort data from the National Health Insurance Service (NHIS), we analyzed patients newly diagnosed with IPD without disabilities between 2012 and 2016. Patients were classified into an acupuncture group (≥six sessions within 1 year of diagnosis) and a non-acupuncture group. Propensity score matching (PSM) was applied, and Cox proportional hazards models were used for survival analysis. During a 6-year follow-up, hazard ratios (HRs) were estimated for overall and cause-specific mortality, emergency room visits, fractures, and the first deep brain stimulation (DBS) procedure, using the non-acupuncture group as the reference. Results: After PSM, 6394 patients were included in each group. The HR for mortality in the acupuncture group was 0.887 (95 % CI: 0.813-0.967), indicating a significantly lower mortality risk. Deaths due to neoplasms and digestive diseases were also lower in the acupuncture group. No significant differences were observed between groups in fracture risk, emergency room visits, or DBS procedures. Conclusions: Acupuncture exposure was associated with a reduced mortality rate in patients with IPD. These findings suggest potential benefits of integrating acupuncture into IPD management, though further long-term randomized controlled trials are needed to confirm these results.