Predictors of Acute Ischemic Stroke After Total Knee Arthroplasty

Although acute ischemic stroke (AIS) is a feared medical complication after total knee arthroplasty (TKA), little is known about its incidence and risk factors. The purpose of this retrospective populationbased study using the Nationwide Inpatient Sample (2008–2011) was to determine the incidence and predictors of AIS following TKA. The rate of perioperative AIS was 0.08%. Patients undergoing bilateral TKA were almost three times more likely to develop AIS compared with unilateral TKA patients. The age group with the highest odds of AIS was ≥85 years. Sex and race and ethnicity were not independently associated with AIS. The comorbidity with the highest risk for AIS was history of stroke, followed by cardiac valvular disease, peripheral vascular disease, atrial fibrillation, complicated diabetes, coagulopathy, and ischemic heart disease. The data in this article might prove useful for preoperative counseling and decision making, resource allocation, and implementation of strategies to minimize the occurrence of AIS after TKA. (Journal of Surgical Orthopaedic Advances 26(3):148–153, 2017) Key words: complications, Nationwide Inpatient Sample, risk, stroke, total knee arthroplasty