Preadmission retirement is associated with abnormal communication after hemorrhagic stroke
Nikhil Avadhani1, Kara Melmed1, Benjamin Brush1, Aaron Lord1, Kaitlin Hanley2, Jennifer Frontera1, Koto Ishida1, Jose Torres1, Leah Dickstein1, David Kahn1, Ting Zhou1, Ariane Lewis1
1Department of Neurology, 2Speech and Language Pathology, NYU Langone Medical Center
Objective:
The objective of this study was to identify preadmission and admission factors associated with abnormal communication after hemorrhagic stroke.
Background:
Hemorrhagic stroke survivors can have deficits in communication ability. Understanding associated factors can guide surveillance and interventions.
Design/Methods:
Patients with non-traumatic intracerebral or subarachnoid hemorrhage (ICH or SAH) admitted at an urban academic medical center between January 2015 and December 2024 were assessed by telephone 3-months post-bleed using the Quality of Life in Neurological Disorders (Neuro-QoL) Communication short form. Univariate and multivariate analysis were used to evaluate the relationship between abnormal communication (Neuro-QoL t-score <100) and preadmission and admission factors in patients with 1) ICH or SAH and 2) ICH only.
Results:
Of 108 patients [68 ICH and 30 SAH; median age 61.5 (IQR 46.8-69.2)], 59 (54.6%) had abnormal communication 3-months post-bleed. On univariate analysis of the full cohort, poor communication was associated with (p<0.05): retirement, admission NIHSS/APACHE II scores, mechanical ventilation, and hospital length-of-stay. On multivariate analysis, poor communication was associated with retirement [OR 12.4 (3.81 – 47.2), p < 0.001], admission NIHSS [OR 1.13 (1.02 – 1.26), p < 0.025], and hospital length-of-stay [OR 1.09 (1.02 – 1.18), p < 0.013]. On univariate analysis of the ICH cohort, poor communication was associated with: retirement, ICH volume, ICH supratentorial location, admission NIHSS score, and hospital length-of-stay. On multivariate analysis, poor communication was associated with retirement [OR 12.6 (2.98 – 70.8), p = 0.001], ICH supratentorial location [OR 7.16 (1.21 – 58.2), p = 0.041], and hospital length-of-stay [OR 1.16 (1.05 – 1.35), p < 0.021].
Conclusions:
Abnormal communication after hemorrhagic stroke is more common in patients who are retired preadmission and have longer hospital stays. Heightened surveillance and early engagement with speech and language therapists is suggested for retired patients with hemorrhagic stroke.
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