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Hip replacement surgery linked to higher stroke risk

Friday November 23, 2012
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Risk of ischemic stroke and hemorrhagic stroke both quadruple during the first two weeks after total hip replacement surgery, according to a study.

“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,” Frank de Vries, PhD, PharmD, the study’s lead author and an assistant professor of pharmacoepidemiology at Utrecht University in the Netherlands, said in a news release.

The 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 ischemic stroke remained elevated for the first six weeks following surgery, while the risk of hemorrhagic stroke remained higher for 12 weeks.

“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.”

Total hip replacement is increasingly common and highly successful in the United States and Europe, the researchers said. About 1 million hip replacement surgeries are performed worldwide each year, with about 300,000 in the U.S., researchers said.

The 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. The majority of study participants were Caucasian and 63.1% were women. The cohort's average age was 72.

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

The researchers planned to continue their investigation of stroke risk following total hip replacement in different populations.

The study appeared Nov. 6 on the website of Stroke, a journal of the American Heart Association. The study abstract is available at http://stroke.ahajournals.org/content/early/2012/11/06/STROKEAHA.112.668509.abstract.


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