Predictors of discharge to home during the first year after right hemisphere stroke.
OBJECTIVE
The aim of this study was to explore predictive factors of the length of hospital stay at the acute stage of right hemisphere stroke. Special attention was paid to the possible role of anosognosia for hemiparesis and anosognosia for neglect in this prediction.


METHODS
A consecutive series of 57 patients having their first right hemisphere stroke were examined at the acute phase. Forty-nine patients were included in this study and followed-up for 12 months. The examinations were conducted within 2 weeks of onset. The outcome variable was the time (days) from stroke to discharge to home. The predictors were age, gender, size of infarct, neglect, hemiparesis, verbal memory, unawareness of illness, anosognosia for neglect, anosognosia for hemiparesis and presence of a relative at home.


RESULTS
Hemiparesis and unawareness of illness lengthened the duration of the hospital stay, the presence of a relative reduced it. Neglect was the best single predictor of poor outcome, but it had no additional value in the combination of the three predictors above. Neither anosognosia for hemiparesis nor anosognosia for neglect were important predictors.


CONCLUSIONS
Hemiparesis, unawareness of illness and presence of a relative at home were the best predictors of the time from right hemisphere stroke to discharge to home.
Jehkonen
M
M
Department of Psychology, University Hospital, University of Tampere, FIN-33521 Tampere, Finland. klmeje@uta.fi
Ahonen
J P
JP
Dastidar
P
P
Koivisto
A M
AM
Laippala
P
P
Vilkki
J
J
Molnár
G
G
D000203:Activities of Daily Living / Q000145:classification; D000368:Aged; D000377:Agnosia / Q000503:physiopathology / Q000534:rehabilitation; D002544:Cerebral Infarction / Q000503:physiopathology / Q000534:rehabilitation*; D004185:Disability Evaluation; D004292:Dominance, Cerebral / Q000502:physiology; D005260:Female; D005387:Finland; D006429:Hemiplegia / Q000503:physiopathology / Q000534:rehabilitation; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D010351:Patient Discharge