Stroke Survivors May Have Higher Risk of Driving Impairment

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Stroke Survivors May Have Higher Risk of Driving Impairment
Stroke Survivors May Have Higher Risk of Driving Impairment

NASHVILLE — New data from two studies presented at the International Stroke Conference 2015 suggest that stroke patients may be at increased risk of committing driving errors, particularly during complex aspects of driving.

“The results … reinforce the importance of physicians discussing driving with their patients, particularly before they go home from the hospital,” Megan A. Hird, MSc candidate at the University of Toronto and researcher of one of the studies, told Neurology Advisor.

In that study, Hird and fellow researchers enrolled 10 patients less than one week after an acute mild ischemic stroke (National Institute of Health Stroke Scale score <7) and compared them with 10 healthy control patients. All patients were well matched with respect to age, years of education, years of driving experience, and number of self-reported accidents.

To test driving performance, patients completed several driving tasks that increased in complexity, including routine right and left turns to cognitively demanding left turns with traffic and a bus following task.

Researchers found that errors were more than twice as common in stroke patients than controls (12.4 vs. 6; P<.01). Furthermore, stroke patients made more errors during left turns with traffic (2.4 vs. 1.3; P<.05) and the bus following task (8.2 vs. 2.1; P<.05).

Groups performed similarly in the number of errors made during routine right and left turns.

Clinical Implications

Although Hird said the results of the study do not influence treatment management, she added that they do support the need for physicians to discuss driving with their patients.

“Patients need to understand and be aware that there may be serious risks in driving after stroke, especially during the acute phase of recovery,” she said in an interview. “There is evidence from other studies that this conversation is not consistently taking place.”

Hird noted that the patients had very minor strokes and appeared to have completely recovered, but were still making errors during certain cognitively demanding aspects of driving.

“In fairness to physicians, though, currently there are not any accurate tools to help them assess the driving fitness of their patients,” she said. “This is a huge issue that needs to be addressed, so that physicians can better inform their patients.”

First-of-Its-Kind Evidence

Also presented was the first study to examine the impact of aneurysmal subarachnoid hemorrhage (aSAH) on driving outcomes.

For the study, Kristin Vesely, MSc candidate at St. Michael's Hospital in Toronto, and colleagues enrolled nine patients with aSAH and nine age-matched controls, who each completed a series of simulated driving scenarios.

Among patients with aSAH, Vesely and colleagues found higher rates of collisions, road edge excursions, total errors, left turn errors, and left turn errors in traffic (P<.05 for all). Differences in right turn errors did not reach statistical significance.

In her presentation, Vesely said that the study highlights the need for future larger-scale studies of driving simulation and studies utilizing functional neuroimaging to determine how driving can be best assessed and rehabilitated after aSAH.

For more coverage of the International Stroke Conference 2015, go here.

References

  1. Hird MA et al. Abstract T P123Presented at: International Stroke Conference 2015; Feb. 11-13, 2015; Nashville, Tennessee. 
  2. Vesely K et al. Abstract W MP54. Presented at: International Stroke Conference 2015; Feb. 11-13, 2015; Nashville, Tennessee.
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