Retrospective analysis of factors that affect driving assessment outcomes after stroke

More than 50% of people do not resume driving post-stroke. Potential disincentives include limited knowledge about assessment, access to services, cost and fear of failure. Factors contributing to a successful return to driving have been the focus of limited research.

To determine the proportion of people with stroke who successfully pass their first on-road occupational therapy driving assessment, and factors associated with a successful assessment outcome.

A retrospective cohort study design was used. The primary data collection method was a review of 441 consecutive occupational therapy driving assessment reports from one Australian metropolitan centre. Participants had a diagnosis of stroke, a driving licence pre-stroke and completed a driving assessment between 1999 and 2010.

Of the 441 records analysed, the mean age of drivers was 65.4 years (SD: 15.4). The majority (53.7%) passed their first assessment (pass/conditional pass); only 8.8% failed. A weak relationship was found between initial driving assessment outcome and time post-stroke (r(s)  = 0.19), but a fair relationship with younger age (r(s)  = 0.31) and higher scores on three off-road assessments (r(s)  = -0.26 to -0.28). The strongest predictors of initial driving assessment outcome were off-road assessment scores, age, gender and time post-stroke (R(2)  = 19.7%, P < 0.01).

Data on stroke severity are required to confirm these preliminary predictors of driving assessment outcome. Stroke severity should be routinely documented by driving assessment services for use in future research.