ArticlePloS one2020
Incidence, predictors, and timing of post-operative stroke following elective total hip arthroplasty and total knee arthroplasty.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 14 citations in OpenAlex.
- Postoperative Complications in Patients With Heart Failure With Reduced vs Preserved Ejection Fraction Undergoing Total Hip and Knee Arthroplasty.Arthroplasty today · 2026Article
- Effect of the time interval between preoperative stroke and total hip arthroplasty on the risk of postoperative stroke and death.Scientific reports · 2025Article
- Risk factors for perioperative nerve injury associated with total knee arthroplasty: Analysis of a national administrative database.PloS one · 2025Article
- Blood Pressure Fluctuation Pattern Associated with 90-Day Ischemic Stroke and Transient Ischemic Attack After Total Knee Arthroplasty-A Retrospective Study.Orthopaedic surgery · 2024Article
- Billing rules / global period affect postoperative follow-up practices following total hip arthroplasty.PloS one · 2024Article
- Integrative Approaches in Acute Ischemic Stroke: From Symptom Recognition to Future Innovations.Biomedicines · 2023Review
- Bone Cement Implantation Syndrome: A Rare Disaster Following Cemented Hip Arthroplasties-Clinical Considerations Supported by Case Studies.Journal of personalized medicine · 2023Article
- Article
- Dual-mobility cup total hip arthroplasty improves the quality of life compared to internal fixation in femoral neck fractures patients with severe neuromuscular disease in the lower extremity after stroke: a retrospective study.Frontiers in surgery · 2023Article
- The association of iron deficiency anemia and perioperative complications following revision total knee arthroplasty.Arthroplasty (London, England) · 2022Article
- Acute middle cerebral artery thrombosis in the early postoperative period after total knee arthroplasty under general anesthesia: A case report.Saudi journal of anaesthesiaArticle
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundPostoperative stroke is a rare but potentially devastating complication following total hip arthroplasty (THA) and total knee arthroplasty (TKA). The purpose of the current study was to determine the incidence, independent risk factors, and timing of stroke following THA and TKA utilizing the National Surgical Quality Improvement (NSQIP) database.
methodsPatients who underwent elective primary THA and TKA were identified in the 2005-2016 NSQIP database. Thirty-day postoperative strokes were identified, timing was characterized, and an incidence curve was created. Multivariate analyses determined the independent predictors of these strokes.
resultsOf 333,117 patients identified, 286 (0.09%) experienced a stroke. Given that THA vs TKA was not a univariate predictor of stroke, the two procedures were considered together. The majority (65%) of strokes occurred before discharge. Of the strokes observed, 25% occurred by postoperative day one, 50% by postoperative day two, and 75% by postoperative day nine. Independent risk factors for postoperative stroke were: age (60-69 years old odds ratio [OR] = 4.2; 70-79 years old OR = 8.1; ≤80 years old OR = 16.1), higher American Society of Anesthesiologists (ASA) score (ASA≥3 OR = 1.7), and smoking [OR = 1.6).
conclusionThe incidence of stroke after THA/TKA was low at 0.09%, with the majority occurring prior to discharge and half occurring by postoperative day two. Patients who were older, sicker, or who were smokers were at greater risk of postoperative stroke. These findings can be used to council patients and to optimize patient care. LEVEL OF EVIDENCE: Level III, Retrospective comparative study.
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