INS NYC 2024 Program

Poster	Poster Session 03 Program Schedule 02/15/2024 09:30 am - 10:40 am Room: Shubert Complex (Posters 1-60) Poster Session 03: Neurotrauma \| Neurovascular Final Abstract #71 Neuropsychological Assessment and Prediction of Supervision Needs Following Stroke Katherine Kitchen Andren, University of Utah School of Medicine, Salt Lake City, United States Christine Mullen, University of Utah School of Medicine, Salt Lake City, United States Masaru Teramoto, University of Utah School of Medicine, Salt Lake City, United States Austin Simpson, University of Utah School of Medicine, Salt Lake City, United States Larissa McGarrity, University of Utah School of Medicine, Salt Lake City, United States Steven Edgley, University of Utah School of Medicine, Salt Lake City, United States Category: Stroke/Cerebrovascular Injury and Disease (Adult) Keyword 1: assessment Keyword 2: cerebrovascular injury Objective: Neuropsychological assessment is an important component of medical rehabilitation and has the potential to enhance patients’ acute rehabilitation, discharge planning, and ongoing care. The aim of this study was to examine neuropsychological and patient factors associated with discharge supervision needs in the context of stroke rehabilitation. Participants and Methods: Participants included adults 18 years or older with stroke admitted to an inpatient medical rehabilitation unit in a large academic medical center who were referred for an inpatient neuropsychological evaluation between May 2019 and February 2021. The brief neuropsychological test battery was comprised of the National Institute of Neurological Disorders and Stroke (NINDS) and Canadian Stroke Network (CSN) battery (i.e., NINDS-CSN battery; Symbol-Digit Modalities, Trail Making Test, Controlled Oral Word Association Test, Animal Naming, and the Hopkins Verbal Learning Test-Revised) with additional measures including single-word oral reading (Test of Premorbid Functioning) and visuospatial (Visual Puzzles from the Wechsler Adult Intelligence Scale-Fourth Edition) and executive functioning (Test of Practical Judgment, Reynolds Interference Task). The outcome variable was supervision needs at the time of discharge, as measured by the Supervision Rating Scale (SRS). Data were analyzed using descriptive statistics, Spearman’s rank correlation coefficients (r_s), and ordinal logistic regression models with the calculation of an odds ratio (OR) and 95% confidence interval (CI) for each coefficient. Results: Of the 88 stroke patients analyzed in this study (n = 39 or 44.3% females; 58.5 ± 18.2 years of age), nine (10.2%), 50 (56.8%) and 29 (33.0%) had SRS of independent, overnight/part-time supervision, and full-time indirect/direct supervision, respectively. Scores on measures of semantic fluency (Animal Naming), complex attention/processing speed (Symbol-Digit Modalities Test), learning (HVLT immediate recall), delayed recall (HVLT delay recall), recognition memory (HVLT recognition), and age had significant correlations with SRS (r_s = 0.23-0.33). Omitting redundant variables and those with limited sample sizes, the ordinal logistic regression model indicated that every 10-point increase in the demographically-corrected normative comparison value for recognition memory was significantly associated with about 1.8 times higher odds of achieving independent status on the SRS (OR = 1.81; 95% CI = 1.17, 2.79; p = 0.008). Further, for every 10 years older in age, the odds of achieving independent status on the supervision rating scale was about 38% lower (OR = 0.62; 95% CI = 0.46, 0.83; p = 0.001). In separate models, immediate and delayed recall from the HVLT were also significantly associated with higher odds of achieving independent status on the SRS including immediate recall (OR = 1.05; 95% CI = 1.01, 1.10; p = 0.030) and delayed recall (OR = 1.06; 95% CI = 1.01, 1.12; p = 0.017). Conclusions: The current study contributes to limited prior work on the utility of early neuropsychological evaluation following stroke. Memory performances as well as age were the most informative factors in predicting supervision needs at the time of discharge from inpatient medical rehabilitation. The ability of immediate recall, delayed recall, and recognition memory to each predict supervision needs lends support to the ecological validity of memory tests in predicting rehabilitation outcomes.

Poster

02/15/2024
09:30 am - 10:40 am
Room: Shubert Complex (Posters 1-60)

Poster Session 03: Neurotrauma | Neurovascular

Final Abstract #71

Neuropsychological Assessment and Prediction of Supervision Needs Following Stroke

Katherine Kitchen Andren, University of Utah School of Medicine, Salt Lake City, United States
Christine Mullen, University of Utah School of Medicine, Salt Lake City, United States
Masaru Teramoto, University of Utah School of Medicine, Salt Lake City, United States
Austin Simpson, University of Utah School of Medicine, Salt Lake City, United States
Larissa McGarrity, University of Utah School of Medicine, Salt Lake City, United States
Steven Edgley, University of Utah School of Medicine, Salt Lake City, United States

Category: Stroke/Cerebrovascular Injury and Disease (Adult)

Keyword 1: assessment
Keyword 2: cerebrovascular injury

Objective:

Neuropsychological assessment is an important component of medical rehabilitation and has the potential to enhance patients’ acute rehabilitation, discharge planning, and ongoing care. The aim of this study was to examine neuropsychological and patient factors associated with discharge supervision needs in the context of stroke rehabilitation.

Participants and Methods:

Participants included adults 18 years or older with stroke admitted to an inpatient medical rehabilitation unit in a large academic medical center who were referred for an inpatient neuropsychological evaluation between May 2019 and February 2021. The brief neuropsychological test battery was comprised of the National Institute of Neurological Disorders and Stroke (NINDS) and Canadian Stroke Network (CSN) battery (i.e., NINDS-CSN battery; Symbol-Digit Modalities, Trail Making Test, Controlled Oral Word Association Test, Animal Naming, and the Hopkins Verbal Learning Test-Revised) with additional measures including single-word oral reading (Test of Premorbid Functioning) and visuospatial (Visual Puzzles from the Wechsler Adult Intelligence Scale-Fourth Edition) and executive functioning (Test of Practical Judgment, Reynolds Interference Task). The outcome variable was supervision needs at the time of discharge, as measured by the Supervision Rating Scale (SRS). Data were analyzed using descriptive statistics, Spearman’s rank correlation coefficients (r_s), and ordinal logistic regression models with the calculation of an odds ratio (OR) and 95% confidence interval (CI) for each coefficient.

Results:

Of the 88 stroke patients analyzed in this study (n = 39 or 44.3% females; 58.5 ± 18.2 years of age), nine (10.2%), 50 (56.8%) and 29 (33.0%) had SRS of independent, overnight/part-time supervision, and full-time indirect/direct supervision, respectively. Scores on measures of semantic fluency (Animal Naming), complex attention/processing speed (Symbol-Digit Modalities Test), learning (HVLT immediate recall), delayed recall (HVLT delay recall), recognition memory (HVLT recognition), and age had significant correlations with SRS (r_s = 0.23-0.33). Omitting redundant variables and those with limited sample sizes, the ordinal logistic regression model indicated that every 10-point increase in the demographically-corrected normative comparison value for recognition memory was significantly associated with about 1.8 times higher odds of achieving independent status on the SRS (OR = 1.81; 95% CI = 1.17, 2.79; p = 0.008). Further, for every 10 years older in age, the odds of achieving independent status on the supervision rating scale was about 38% lower (OR = 0.62; 95% CI = 0.46, 0.83; p = 0.001). In separate models, immediate and delayed recall from the HVLT were also significantly associated with higher odds of achieving independent status on the SRS including immediate recall (OR = 1.05; 95% CI = 1.01, 1.10; p = 0.030) and delayed recall (OR = 1.06; 95% CI = 1.01, 1.12; p = 0.017).

Conclusions:

The current study contributes to limited prior work on the utility of early neuropsychological evaluation following stroke. Memory performances as well as age were the most informative factors in predicting supervision needs at the time of discharge from inpatient medical rehabilitation. The ability of immediate recall, delayed recall, and recognition memory to each predict supervision needs lends support to the ecological validity of memory tests in predicting rehabilitation outcomes.