Hemineglect in acute stroke--incidence and prognostic implications. The Copenhagen Stroke Study

Widely different incidences have been found for hemineglect in acute stroke, and there is no agreement on the consequences of hemineglect for activities of daily living recovery. We assessed acute admission visuo-spatial and personal hemineglect in a prospective, community-based study of 602 consecutive stroke patients. Hemineglect was found in 23%. Functional outcome was assessed with the Barthel Index (BI), length of rehabilitation, mortality, and rate of discharge to independent living. The independent influence of hemineglect on outcome was analyzed with multiple linear and logistic regression analysis also including functional and neurologic scores on admission, age, gender, previous stroke, comorbidity, anosognosia, orientation, and aphasia. Marital status was also included in the analysis of determinants of discharge to independent living. Hemineglect had no independent influence on admission BI, discharge BI, length of hospital stay used for rehabilitation, mortality, or rate of discharge to independent living. It is concluded that hemineglect per se has no negative prognostic influence on functional outcome.