title: Driving in stroke survivors aged 18-65 years: The Psychosocial Outcomes In StrokE (POISE) Cohort Study.
abstract: There is limited information regarding return to driving after stroke.
  
  
  
  To determine the frequency and predictors of return to driving within 1 month of acute stroke in younger (age 18-65 years) adults.
  
  
  
  POISE (Psychosocial Outcomes In StrokE) was a cohort study conducted in Australia between October 2008 and June 2010. Consecutive patients (age 18-65 years) with a recent (≤28 days) acute stroke were recruited. Validated demographic, clinical, mental health, cognitive, and disability measures including return to driving were obtained. Multivariable logistic regression was used to determine factors associated with return to driving within 1 month of stroke.
  
  
  
  Among 359 participants who were legally able to drive before stroke, 96 (26.7%) returned to driving within 1 month. Compared to those without an early return to driving (n = 263), drivers were more often male, the main income earner, in paid work before stroke and without symptoms of depression or fatigue. Independence in activities of daily living (odds ratio (OR) 30.05, 95% confidence interval (CI) 3.85-234.45), not recalling receiving advice on driving cessation (OR 5.55, 95% CI 2.86-11.11), and having returned to paid work (OR 3.93, 95% CI 1.94-7.96) were associated with early return to driving.
  
  
  
  One in four young adults resumed driving within a month, contrary to guideline recommendations. These data reinforce the importance of deciding who is responsible for determining fitness to drive after stroke, when, and whether it is reasonable to enforce driving restrictions on those with minimal disability who are fit to return to work.
  
  
  
  Australian New Zealand Clinical Trials Registry ANZCTRN 12608000459325.
authors.affiliation: Department of Neurology, Korea University College of Medicine, Seoul, Republic of Korea The George Institute for Global Health, University of Sydney and Royal Prince Alfred Hospital, Sydney, Australia.
authors.forename: Sungwook
authors.initials: S
authors.lastname: Yu
authors.affiliation: The George Institute for Global Health, University of Sydney and Royal Prince Alfred Hospital, Sydney, Australia.
authors.forename: Janani
authors.initials: J
authors.lastname: Muhunthan
authors.affiliation: The George Institute for Global Health, University of Sydney and Royal Prince Alfred Hospital, Sydney, Australia Westmead Clinical School, University of Sydney, Sydney, Australia.
authors.forename: Richard
authors.initials: R
authors.lastname: Lindley
authors.affiliation: Psychological Medicine, Brain and Mind Centre, Sydney Medical School, University of Sydney, Sydney, Australia.
authors.forename: Nick
authors.initials: N
authors.lastname: Glozier
authors.affiliation: The George Institute for Global Health, University of Sydney and Royal Prince Alfred Hospital, Sydney, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Jan
authors.affiliation: The George Institute for Global Health, University of Sydney and Royal Prince Alfred Hospital, Sydney, Australia.
authors.forename: Craig
authors.initials: C
authors.lastname: Anderson
authors.affiliation: The George Institute for Global Health, University of Sydney and Royal Prince Alfred Hospital, Sydney, Australia.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Li
authors.affiliation: The George Institute for Global Health, University of Sydney and Royal Prince Alfred Hospital, Sydney, Australia School of Health, The University of Central Lancashire, Preston, UK mhackett@georgeinstitute.org.au.
authors.forename: Maree L
authors.initials: ML
authors.lastname: Hackett
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia; D001334:Automobile Driving; D003863:Depression / Q000453:epidemiology; D004185:Disability Evaluation; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D012737:Sex Factors; D012959:Socioeconomic Factors; D020521:Stroke / Q000453:epidemiology* / Q000523:psychology; D017741:Survivors; D013997:Time Factors; D055815:Young Adult
keywords: Stroke; driving; epidemiology; public health