Hysterectomy does not increase the risk of hemorrhagic or ischemic stroke over a mean follow-up of 6 years: A longitudinal national cohort study

Objectives: This study sought to evaluate the association between hysterectomy and the occurrence of stroke in a Korean national cohort. Study design: Data from 2002 to 2013 were collected for individuals in the Korean National Health Insurance Service-National Cohort. We extracted data for patients who had undergone a hysterectomy (N = 11,280) and a 1:4 matched control group (N = 45,120) and then analyzed the occurrence of stroke. The patients were matched according to age, sex, income, region of residence, and medical history. Main outcome measures: Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using a Cox proportional hazards model. Subgroup analyses were based on age (those under and those over 45 years of age) and type of hysterectomy (with or without bilateral oophorectomy). Results: No significant difference in risk of hemorrhagic stroke (adjusted HR = 0.91, p = 0.592) or ischemic stroke (adjusted HR = 0.85, p = 0.188) was found between women with and without hysterectomy. No significant differences were found in the subgroup analyses according to age or type of hysterectomy for hemorrhagic and ischemic stroke. Conclusion: Over a mean follow-up of 6 years, hysterectomy is not associated with an increased risk of either ischemic or hemorrhagic stroke at any age after adjusting for CVD risk factors including, hypertension, diabetes mellitus, and dyslipidemia, regardless of bilateral oophorectomy.