<p style="text-align: center;">Chun-Chuan Shih1,2,3</p><p style="text-align: center;">(1School of Chinese Medicine for Post-Baccalaureate, College of Medicine, I-Shou University, Kaohsiung, Taiwan; 2Ph.D. Program for Clinical Drug Discovery from Botanical Herbs, Taipei Medical University, Taipei, Taiwan; 3Chinese Medical Association of Acupuncture, Taichung, Taiwan)</p><p style="text-align: justify;"><strong>Abstract: Background:</strong> Acupuncture treatment is common among stroke patients, but there is limited information availableon whether acupuncture effectively prevents post-stroke pneumonia. The aim of this study was to analyze the differential risk of pneumonia after stroke between patients who did and did notreceive acupuncture after discharge. <strong>Methods: </strong>We used the Taiwan National Health Insurance Research Database to conduct a retrospective cohort study using propensity score matched-pairs of new stroke patients in 2000-2004 who didand did not receive acupuncture post-stroke. Both cohorts were followedup until the end of 2009 for new-onset pneumonia. After correcting for immortal time bias, the incidence and adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) of pneumonia associated with acupuncture use were calculated using multivariate Cox proportional hazard models.</p><p style="text-align: justify;"><strong>Results:</strong> Overall, 13,013 stroke patients with 13,013 paired controls were included in the analysis; pneumonia was diagnosed in 7118 (27.3%). Stroke patients receiving acupuncture had a lower incidence of pneumonia than those without acupuncture (54.2 vs. 59.8 per 1000 person-years), with an adjusted HR of 0.85 (95% CI 0.82-0.90). The association between pneumonia risk and acupuncture use was significant in men (HR 0.91, 95% CI 0.86-0.96) and women (HR 0.77, 95% 0.71-0.83) and was also observed in every age group from 20-79 years.Conclusion: Stroke patients receiving acupuncture had a lower risk of pneumonia than those who did not. Further randomized control studies are needed to validate the protective effect of acupuncture on the risk of pneumoniaamong stroke patients.</p><p><br/></p><p><strong>Key Words: </strong>Acupuncture; Stroke; Pneumonia</p><p><br/></p>