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. 2019 Dec 13;9(12):374.
doi: 10.3390/brainsci9120374.

Spatial Neglect in Stroke: Identification, Disease Process and Association with Outcome During Inpatient Rehabilitation

Ulrike Hammerbeck  1 , Matthew Gittins  2 , Andy Vail  2 , Lizz Paley  3 , Sarah F Tyson  4 , Audrey Bowen  1
Affiliations

Spatial Neglect in Stroke: Identification, Disease Process and Association with Outcome During Inpatient Rehabilitation

Ulrike Hammerbeck et al. Brain Sci. .

Abstract

We established spatial neglect prevalence, disease profile and amount of therapy that inpatient stroke survivors received, and outcomes at discharge using Sentinel Stroke National Audit Programme (SSNAP) data. We used data from 88,664 National Health Service (NHS) admissions in England, Wales and Northern Ireland (July 2013-July 2015), for stroke survivors still in hospital after 3 days with a completed baseline neglect National Institute for Health Stroke Scale (NIHSS) score. Thirty percent had neglect (NIHSS item 11 ≥ 1) and they were slightly older (78 years) than those without neglect (75 years). Neglect was observed more commonly in women (33 vs. 27%) and in individuals with a premorbid dependency (37 vs. 28%). Survivors of mild stroke were far less likely to present with neglect than those with severe stroke (4% vs. 84%). Those with neglect had a greatly increased length of stay (27 vs. 10 days). They received a comparable amount of average daily occupational and physiotherapy during their longer inpatient stay but on discharge a greater percentage of individuals with neglect were dependent on the modified Rankin scale (76 vs. 57%). Spatial neglect is common and associated with worse clinical outcomes. These results add to our understanding of neglect to inform clinical guidelines, service provision and priorities for future research.

Keywords: dependency; length of stay; outcomes; rehabilitation; severity; spatial neglect; stroke; therapy.

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Conflict of interest statement

At the time the analysis was undertaken Dr. Bray and Ms. Paley were employed by the Stroke Sentinel Stroke Audit Programme. Prof Bowen was until 2016 a member of the Intercollegiate Stroke Working Party that produces SSNAP from which the SSNAPIEST data were drawn and her University salary is part-funded by a personal award from Stroke Association. Prof. Tyson is currently a member of the Intercollegiate Stroke Working Party.

References

    1. Li K., Malhotra P.A. Spatial neglect. Pract. Neurol. 2015;15:333–339. doi: 10.1136/practneurol-2015-001115. - DOI - PMC - PubMed
    1. Di Monaco M., Schintu S., Dotta M., Barba S., Tappero R., Gindri P. Severity of unilateral spatial neglect is an independent predictor of functional outcome after acute inpatient rehabilitation in individuals with right hemispheric stroke. Arch. Phys. Med. Rehabil. 2011;92:1250–1256. doi: 10.1016/j.apmr.2011.03.018. - DOI - PubMed
    1. Rode G., Pagliari C., Huchon L., Rossetti Y., Pisella L. Semiology of neglect: An update. Ann. Phys. Rehabil. Med. 2017;60:177–185. doi: 10.1016/j.rehab.2016.03.003. - DOI - PubMed
    1. Kerkhoff G., Rossetti Y. Plasticity in spatial neglect: Recovery and rehabilitation. Restor Neurol Neurosci. 2006;24:201–206. - PubMed
    1. Cubelli R. Definition: Spatial neglect. Cortex J. Devoted Study Nerv. Syst. Behav. 2017;92:320–321. doi: 10.1016/j.cortex.2017.03.021. - DOI - PubMed

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