期刊
EUROPEAN JOURNAL OF NEUROLOGY
卷 24, 期 11, 页码 1407-1415出版社
WILEY
DOI: 10.1111/ene.13406
关键词
ischemic stroke; language impairment; long-term functional outcome; visuospatial inattention
资金
- Swedish Research Council [K2014-64X-14605-12-5]
- Sahlgrenska University Hospital [ALFGBG-429981, ALFGBG-430841]
- Swedish Heart and Lung Foundation [20130315]
- Skaraborg Institute for Research and Development
- Swedish Stroke Association
- Rune and Ulla Amlovs Foundation for Neurological Research
- John and Brit Wennerstrom Foundation for Neurological Research
- Per-Olof Ahl Foundation for Neurological Research
- Stroke Centre West
- Gothenburg Foundation for Neurological Research
- Hjalmar Svensson Research Foundation
- Greta and Einar Askers Foundation
Background and purposeVisuospatial inattention (VSI) and language impairment (LI) are often present early after stroke and associations with an unfavorable short-term functional outcome have been reported. The purpose of this study was to investigate whether a screening of VSI and LI as indicators of cortical symptoms early after stroke could predict long-term functional outcomes. MethodsA consecutive cohort of 375 patients with ischemic stroke was assessed for the occurrence of VSI at a median of 7 days after admission (interquartile range, 1-5 days) using the Star Cancellation Test and for LI (within the first 7 days) with the language item in the Scandinavian Stroke Scale. Seven years later, functional outcomes were assessed by the modified Rankin scale and Frenchay Activities Index in 235 survivors without recurrent stroke. Relationships between baseline predictors and functional outcome at 7 years were analyzed with bivariate correlations and multiple categorical regressions with optimal scaling. ResultsThe regression model significantly explained variance in the modified Rankin scale (R-2 = 0.435, P < 0.001) and identified VSI (P = 0.001) and neurological deficits (P < 0.001; Scandinavian Stroke Scale score without the language item) as the significant independent predictors. The model for Frenchay Activities Index was also significant (R-2 = 0.269, P < 0.001) with VSI (P = 0.035) and neurological deficits (P < 0.001) as significant independent predictors. ConclusionsVisuospatial inattention at acute stroke has an independent impact on long-term functional outcomes. Early recognition may enable targeted rehabilitative interventions.
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