Patients With Hemispatial Neglect Are More Prone to Limb Spasticity, but This Does Not Prolong Their Hospital Stay

Abstract

Wilkinson D, Sakel M, Camp S-J, Hammond L. Patients with hemispatial neglect are more prone to limb spasticity, but this does not prolong their hospital stay. ObjectiveTo determine whether stroke patients who suffer from hemispatial neglect tend to stay in hospitals longer because they are prone to limb spasticity. DesignRetrospective analysis of inpatient medical notes. SettingInpatient neurorehabilitation unit of a regional UK teaching hospital. ParticipantsAll patients (N=106) admitted to the neurorehabilitation unit between 2008 and 2010 who had suffered a stroke, as confirmed by computed tomography or magnetic resonance imaging. InterventionsNot applicable. Main Outcome MeasuresStatistical coincidence of hemispatial neglect and spasticity; length of hospital stay. ResultsChi-square analyses indicated that individuals with left neglect were nearly one third more likely to develop spasticity than those without neglect (87% vs 57%), while nearly one half of those with left-sided spasticity showed neglect (44% vs 13%). Individuals with neglect stayed in the hospital 45 days longer than those without neglect, but the presence or absence of spasticity did not affect length of stay. ConclusionsThe results provide the first statistical evidence, to the best of our knowledge, that neglect and limb spasticity tend to co-occur poststroke, though it is only the former that significantly prolongs stay. Diagnostic value aside, these results are important because they tell us that the treatment of neglect should not be overshadowed by efforts to reduce comorbid spasticity. Despite its poor prognosis, hemispatial neglect continues to receive little targeted therapy in some units.