Strokes 4 to 5 times more likely right after hip replacement, study shows

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Individuals who underwent a total hip replacement had at least four times the risk of suffering an ischemic or hemorrhagic stroke in the weeks immediately following, a Dutch study has revealed. Researchers say more cautious monitoring after such a procedure is warranted.

Hip replacement patients showed nearly five times the rate of ischemic stroke than a control group (26 per 1,000 person-years vs. 5.6). The rate of hemorrhagic stroke was a little more than four times as much (6.7 vs. 1.6 per 1,000 person-years).

The rates were highest in the two weeks following surgery but declined quickly thereafter, evening out after six to 12 weeks, said Frank de Vries, PharmD, PhD, of the Utrecht Institute of Pharmaceutical Sciences in the Holland, one of the researchers. His team's work is detailed online in Stroke: Journal of the American Heart Association.

“Risk assessment of stroke in individual patients undergoing total hip replacement (i.e. evaluate other risk factors for stroke) should be considered during the first 6 to 12 weeks,” the researchers wrote.

They said that “the underlying mechanism” for the greater stroke risk is “thought to be related to cerebral hypoperfusion and marrow embolization.” But they cautioned against drawing concrete conclusions without further study. They examined records of 200,000 individuals, including more than 66,000 who had total hip replacement from 1998 to 2007, to reach their findings.

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