Stroke risk with total hip replacement

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Patients who undergo total hip replacement surgery may have a four- to five-fold increased chance of stroke within the first two weeks, a recent study suggests.

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, Dr. Frank de Vries, lead author and assistant professor at Utrecht University in the Netherlands, stated in a press release.

Published in the journal Stroke, the retrospective study found over 66,000 patients in Danish registries who underwent total hip replacement surgery and compared them to 200,000 who did not have the surgery. Subjects who were mainly white, average age of 72, and 63 percent women were monitored for timing of strokes over various intervals postoperatively: during the first two weeks following total hip replacement surgery; between two and six weeks afterwards; six to twelve weeks; three to six months; and six to twelve months.

Results showed that the risk of stroke rose four- to fivefold during the first two weeks following surgery, with the risk diminishing after six to 12 weeks; at one year, the stroke risk was comparable to those who did not undergo surgery.
Furthermore, researchers also analyzed the role of several drugs in decreasing stroke risk. The results reveal that patients who took aspirin had a reduced risk of stroke by anywhere up to 70 percent, compared to those people not taking aspirin.

Although this study leaves us with serious concern that total hip replacement surgery has something to do with increased risk of stroke, we cannot say that it causes these events, says ACSH s Dr. Gilbert Ross. An observational study, such as this one, cannot conclude direct cause and effect. The numbers however are significant, and doctors and patients should both be aware of the increased risk of stroke especially during the early post-surgery period.