The influence of visual and tactile inattention on predictions for recovery from acute stroke

Simple screening tests for visual and tactile inattention were used to investigate the influence of perceptual deficits on predictions for the outcome of acute stroke. This influence appeared to be minimal in patients aged over 70 and greatest in younger patients who were incontinent or more severely functionally impaired at the time of the perceptual assessment. When multivariate analysis was used to control for the effects of other prognostic factors, the relationship between visual inattention/hemianopia and functional outcome became very weak, but there was still a significant association with length of stay in hospital. By contrast, even after adjusting for covariates, tactile inattention at one month was still associated with a greater degree of functional impairment at six months. These results could have important practical implications. Poor performance on visuospatial tests may indicate the need for more prolonged rehabilitation rather than predicting failure of recovery. The inclusion of a test for tactile inattention may improve the predictive power of perceptual testing. Further prospective studies are needed to test these hypotheses.