Barer D H
Department of Medicine, University Hospital, Nottingham.
Q J Med. 1990 Jan;74(273):21-32.
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.
使用简单的视觉和触觉疏忽筛查测试来研究感知缺陷对急性中风预后预测的影响。这种影响在70岁以上的患者中似乎最小，而在感知评估时大小便失禁或功能障碍更严重的年轻患者中最大。当使用多变量分析来控制其他预后因素的影响时，视觉疏忽/偏盲与功能结局之间的关系变得非常微弱，但与住院时间仍存在显著关联。相比之下，即使在调整协变量后，一个月时的触觉疏忽仍与六个月时更大程度的功能障碍相关。这些结果可能具有重要的实际意义。视觉空间测试表现不佳可能表明需要更长时间的康复，而不是预测恢复失败。纳入触觉疏忽测试可能会提高感知测试的预测能力。需要进一步的前瞻性研究来验证这些假设。
