Table 4 Causality assessment based on the modified WHO-UMC criteria
Study ID (author, year) | Authors’ conclusion on the causal relationship between acupuncture and adverse events (Quotation from studies) | Causality assessment* |
|---|---|---|
Bahn (1999) [34] | “We experienced an interesting case of traumatic CSF rhinorrhea associated with acupuncture.” | Probable/likely |
Chun (2014) [19] | “The diagnosis of cardiac tamponade induced by an acupuncture needle should be considered when unexplained shock after an acupuncture procedure at the chest wall is found.” | Unlikely |
Chung (2008) [16] | “We present the case of a 66-year-old male with a long-standing history of type 2 diabetes who presented with a painful left lower extremity after needle acupuncture and was diagnosed with acute compartment syndrome.” | Unlikely |
Chung (2016) [40] | “We observed a case of ocular perforation and endophthalmitis following ocular acupuncture treatment. This case illustrates the dangers of intraocular acupuncture therapy.” | Possible |
Chung (2020) [33] | “In conclusion, we report a case of reversible duodenal obstruction due to a large retroperitoneal hematoma after acupuncture therapy.” | Unassessable/Unclassifiable |
Ha (2009) [17] | “We report here on a case of a retropharyngeal hematoma following acupuncture therapy and we review the relevant literature.” | Unlikely |
Her (2013) [14] | “We report a case of 62-year-old man with cardiac tamponade due to coronary artery injury after acupuncture into the substernum.” | Certain |
Hong (2006) [24] | “We had experienced … pseudoaneurysms that occurred after acupuncture … and the patients were treated successfully with interventional and surgical procedures.” | Unassessable/Unclassifiable |
Hwang (2008) [26] | “This report describes a case of pneumoretroperitoneum that developed after acupuncture.” | Unassessable/Unclassifiable |
Jeon (2004) [22] | “It is probable that the acupuncture needle had been inserted deep enough to enter the cisterna magna and provoked a small hemorrhage in the cistern.” | Unassessable/Unclassifiable |
Kang (2013) [30] | “We report the case of ocular perforation and retinal tear with normal retinal function and persistent visual field impairment due to retinal nerve fiber severance, caused by acupuncture treatment, which has not yet been reported in Korea.” | Unassessable/Unclassifiable |
Koo (2022) [21] | “We herein report a case of a traumatic vertebro-vertebral arteriovenous fistula that occurred following the application of oriental acupuncture in the posterior neck region.” | Unlikely |
Kim (2006) [25] | “This report describes a case of spinal cord infarction after acupuncture.” | Unassessable/Unclassifiable |
Kim (2009) [27] | “Recently, we experienced … perirenal hematoma in patients without blood coagulation abnormalities (one case induced by acupuncture in oriental medicine clinic…).” | Unassessable/Unclassifiable |
Kim (2011a) [36] | “In the following case, cardiac tamponade was caused by epigastric acupuncture.” | Probable/likely |
Kim (2011b) [18] | “The purpose of this report is to describe what we believe to be the first case of delayed superficial and deep peroneal nerve compressive neuropathy caused by fibrotic mass formed by neglected broken acupuncture needle.” | Unlikely |
Kim (2011c) [37] | “We report a case of hemopericardium that occurred shortly after acupuncture … “ | Possible |
Lee (2001) [13] | “In order to make known that acupuncture can cause pneumothorax in reality and to prevent more acupuncture-related adverse effect cases in future, this report was made.” | Certain |
Lee (2005) [23] | “We report the case of 75-year-old woman with an intramural hematoma who took cumadin after acupuncture …” | Unassessable/Unclassifiable |
Lee (2008) [35] | “This case highlights the possibility of a focal peripheral nerve lesion resulting from acupuncture, possibly caused by herbal medicine coating the needle.” | Possible |
Lee (2020) [39] | “Authors present a case of a patient with vitreous hemorrhage and ocular perforations caused by periocular acupuncture therapy in both eye, …” | Probable/likely |
Moon (2013a) [29] | “We report a rare case of haemorrhage from the inferior epigastric artery, which was injured after acupuncture.” | Unassessable/Unclassifiable |
Moon (2013b) [38] | “We report here on a case of an iliocecal vein rupture following acupuncture therapy and we review the relevant literature.” | Possible |
Park (2013) [28] | “In this report, we present an atypical case of SDH with unilateral weakness after acupuncture …” | Unassessable/Unclassifiable |
Park (2019) [31] | “This patient has functional dysfunction due to SSDH after the acupuncture, which shows that even severe complications may occur after acupuncture.” | Unassessable/Unclassifiable |
Sung (2016) [15] | “For acupuncture treatment to the interscapular area, the depth and manual technique should be carefully performed.” | Certain |
Woo (2020) [32] | “The authors report a case of cervical neurological damage that occurred after an acupuncture procedure.” | Unassessable/Unclassifiable |
Yeo (2021) [20] | “To the best of our knowledge, this is the first case to report the occurrence of bladder injury with VCF following acupuncture. “ | Unlikely |