First‐ever stroke following hip replacement surgeries: a large population‐based survey

Objective This study was designed to determine the prevalence, subtypes and risk factors of first‐ever stroke following hip replacement ( HR ) in a large population of Taiwan. Methods Using the National Health Insurance system of Taiwan, we identified patients undergoing HR from 2000 to 2011 and randomly selected 4 : 1 age‐ and sex‐matched controls for each HR patients. The index date for HR patients was defined the date for HR . All study subjects were followed from the index date until stroke occurred at admission. T ‐test and chi‐square test were used for continuous and categorical variables, respectively. The hazard ratios of risk factors were determined with Cox proportional hazard regression model. Results A total of 3604 HR patients and 14 394 controls were enrolled. In comparison with controls, patients undergoing HR had a significantly higher incidence of comorbidities (i.e. atrial fibrillation, hypertension, diabetes) and consumed more medications (i.e. antihypertension, antidiabetes, nonsteroid anti‐inflammatory drugs and anticoagulants) before surgery. The HR patients had a significant higher incidence of first‐ever stroke, especially for those aged over 65. (Hazard ratio: 1·33, 95% confidence interval: 1·12–1·58) The significantly higher risk for first‐ever stroke occurred within 3 months and ≥ 1 year after HR . The incidence rate of ischaemic stroke is about five times than that of haemorrhagic stroke. Conclusion Our study identifies multiple risk factors that cause cerebrovascular complications after HR , which is vital in creating treatment plans to prevent for said problems.