Prediction for return to driving after the first-ever stroke in Korea: The KOSCO study
Sungju Jee, Min Kyun Sohn, Jongmin Lee, Deog Young Kim, Sam-Gyu Lee, Yong-Il Shin, Gyung-Jae Oh, Yang-Soo Lee, Min Cheol Joo, Eun Young Han, Yun-Hee Kim
Department of Rehabilitation Medicine, School of Medicine, Chungnam National University, Daejeon, South Korea
Objective: To identify contributing factors that can be used to predict which patients with first-ever stroke will return to driving during 1 year after stroke.
Design: Multicentre cohort study.
Subjects: A total of 620 first-ever stroke patients who drove before stroke.
Methods: The Stroke Cohort for Functioning and Rehabilitation is a large, multicentre, prospective cohort study of all patients with acute first-ever stroke admitted to participating hospitals in 9 areas of Korea.
This study analysed the data from 1,354 patients who completed a face-to-face survey about return to driving at 1 year after stroke. A multiple binary logistic regression analysis model was used to analyse factors that potentially influenced return to driving during 12 months after stroke.
Results: Of 620 subjects, 410 (66.1%) returned to driving after stroke. They resumed driving at a mean of 2.15 months after stroke (standard deviation 2.32 years). Regression models showed that sex, age, modified Rankin scale (mRS), education about return to driving, and Fugl-Meyer Assessment (FMA) were significantly related to return to driving. Stroke type, ambulatory function, and language function at 7 days were not correlated with return to driving.
Conclusion: Male patients, education about return to driving, lower mRS, and higher FMA at 7 days after stroke are predictors of return to driving. This model could be used by clinicians to help counsel patients and their families.
In terms of social participation, ability to drive is one of the most important activities for stroke survivors. However, it is difficult for healthcare providers to predict and provide guidance about return to driving during the early phase of stroke. Various predictive factors for return to driving were analysed among 620 patients with mild first-ever stroke. Sex, motor deficit, and stroke severity at 7 days after stroke were significant predictors for return to driving at 1 year after stroke. Using the Fugl Meyer Assessment score and the National Institutes of Health Stroke Scale, clinicians may be able to screen for stroke patients who have high probability of returning to driving at an early phase of stroke. This study may help healthcare professionals to advise stroke patients and their families concerning the likelihood of returning to driving.
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