Effect of the time interval between preoperative stroke and total hip arthroplasty on the risk of postoperative stroke and death

Although postoperative strokes after total hip arthroplasty are infrequent, they result in severe injury and can be fatal. This retrospective cohort study employed data from the nationwide research database. The study comprised 44,752 patients aged ≥ 40 years who received total hip arthroplasty from 2005 to 2017. The population were categorized into two groups based on the presence or absence of preoperative stroke. Patients with preoperative stroke exhibited a 4.37 times higher risk of postoperative stroke than did those without preoperative stroke (95% confidence interval [CI]: 1.82-10.48). Moreover, patients with preoperative stroke exhibited a 33.19 times higher risk of postoperative stroke when the elapsed time between preoperative stroke and surgery was less than 180 days (95% CI: 9.12-120.77). However, when the elapsed time was more than 365 days, the risk of postoperative stroke was only 2.25 times higher (95% CI: 0.69-7.32). Furthermore, patients with preoperative stroke had a 1.22 times higher risk of postoperative death (95% CI: 0.68-2.15), but this result is not statistically significant. In conclusion, delaying total hip arthroplasty for at least 1 year after stroke may lower the risk of postoperative stroke.