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Total hip replacement surgery may increase risk of stroke

Risk of ischaemic stroke increases by nearly 4.7-fold and haemorrhagic stroke 4.4-fold during the first two weeks after total hip replacement surgery, according to new research in the American Heart Association journal Stroke.

“This is the first study to evaluate the risk of stroke in patients undergoing total hip replacement compared to people in the general population who did not undergo the surgery, but were matched for age, sex and geographical region,” said lead author Dr Frank de Vries (Assistant Professor of Pharmacoepidemiology, Utrecht University, the Netherlands).

“It makes sense to evaluate the risk of stroke two weeks after surgery. There is an increasing tendency to decrease the length of hospital stay because of improved therapy and because of strategies to reduce costs and mobilise patients as soon as possible.”

Researchers evaluated the timing of strokes in the first two weeks after total hip replacement surgery; in two to six weeks; six to 12 weeks; three to six months; and six to 12 months.

The risk of ischaemic stroke remained elevated for the first six weeks following surgery and for the first 12 weeks for haemorrhagic stroke.

“Up to one year following surgery, there is diminishing risk of stroke after six to 12 weeks,” de Vries said. “At one year, the stroke risk is comparable to those who did not undergo surgery.”

Researchers identified 66,583 patients in Danish registries who had undergone total hip replacement and compared them to 199,995 who had not undergone the surgery. Study participants were an average 72 years old, majority Caucasian and 63.1% women.

In another aspect of the study, researchers examined the role of various medications in reducing the risk of stroke. The findings show that patients who were using aspirin had a lower risk of stroke by as much as 70%, compared to those who did not take aspirin. Other medications didn’t show an effect.

Researchers plan to continue their investigation of stroke risk following total hip replacement in different populations.

References

1. Lalmohamed A, Vestergaard P, Cooper C, de Boer A, Leufkens HG, van Staa TP, de Vries F. Timing of stroke in patients undergoing total hip replacement and matched controls: a nationwide cohort study. Stroke 2012. http://dx.doi.org/10.1161/​STROKEAHA.112.668509/

Published on: November 15, 2012

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  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association
 

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