A systematic review of the risk of motor vehicle collision after stroke or transient ischemic attack

Mark J. Rapoport, Sarah C. Plonka, Hillel Finestone, Mark Bayley, Justin N. Chee, Brenda Vrkljan, Sjaan Koppel, Elizabeth Linkewich, Judith L. Charlton, Shawn Marshall, Martin delCampo, Mark I. Boulos, Richard H. Swartz, Jaspreet Bhangu, Gustavo Saposnik, Jessica Comay, Jamie Dow, Debbie Ayotte, Desmond O’Neill

Research output: Contribution to journalReview ArticleResearchpeer-review

Abstract

Background: Returning to driving after stroke is one of the key goals in stroke rehabilitation, and fitness to drive guidelines must be informed by evidence pertaining to risk of motor vehicle collision (MVC) in this population. Objectives: The purpose of the present study was to determine whether stroke and/or transient ischemic attack (TIA) are associated with an increased MVC risk. Methods: We searched MEDLINE, CINAHL, EMBASE, PsycINFO, and TRID through December 2016. Pairs of reviewers came to consensus on inclusion, based on an iterative review of abstracts and full-text manuscripts, on data extraction, and on the quality of evidence. Results: Reviewers identified 5,605 citations, and 12 articles met inclusion criteria. Only one of three case-control studies showed an association between stroke and MVC (OR 1.9, 95% CI 1.0–3.9). Of five cohort reports, only one study, limited to self-report, found an increased risk of MVC associated with stroke or TIA (RR 2.71, 95% CI 1.11–6.61). Two of four cross-sectional studies using computerized driving simulators identified a more than two-fold risk of MVCs among participants with stroke compared with controls. The difference in one of the studies was restricted to those with middle cerebral artery stroke. Conclusions: The evidence does not support a robust increase in risk of MVCs. While stroke clearly prevents some patients from driving at all and impairs driving performance in others, individualized assessment and clinical judgment must continue to be used in assessing and advising those stroke patients who return to driving about their MVC risk.

Original languageEnglish
Pages (from-to)226-235
Number of pages10
JournalTopics in Stroke Rehabilitation
Volume26
Issue number3
DOIs
Publication statusPublished - 3 Apr 2019

Keywords

  • Accidents
  • automobile driving
  • ischemic attack
  • stroke
  • traffic
  • transient

Cite this

Rapoport, M. J., Plonka, S. C., Finestone, H., Bayley, M., Chee, J. N., Vrkljan, B., ... O’Neill, D. (2019). A systematic review of the risk of motor vehicle collision after stroke or transient ischemic attack. Topics in Stroke Rehabilitation, 26(3), 226-235. https://doi.org/10.1080/10749357.2018.1558634
Rapoport, Mark J. ; Plonka, Sarah C. ; Finestone, Hillel ; Bayley, Mark ; Chee, Justin N. ; Vrkljan, Brenda ; Koppel, Sjaan ; Linkewich, Elizabeth ; Charlton, Judith L. ; Marshall, Shawn ; delCampo, Martin ; Boulos, Mark I. ; Swartz, Richard H. ; Bhangu, Jaspreet ; Saposnik, Gustavo ; Comay, Jessica ; Dow, Jamie ; Ayotte, Debbie ; O’Neill, Desmond. / A systematic review of the risk of motor vehicle collision after stroke or transient ischemic attack. In: Topics in Stroke Rehabilitation. 2019 ; Vol. 26, No. 3. pp. 226-235.
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title = "A systematic review of the risk of motor vehicle collision after stroke or transient ischemic attack",
abstract = "Background: Returning to driving after stroke is one of the key goals in stroke rehabilitation, and fitness to drive guidelines must be informed by evidence pertaining to risk of motor vehicle collision (MVC) in this population. Objectives: The purpose of the present study was to determine whether stroke and/or transient ischemic attack (TIA) are associated with an increased MVC risk. Methods: We searched MEDLINE, CINAHL, EMBASE, PsycINFO, and TRID through December 2016. Pairs of reviewers came to consensus on inclusion, based on an iterative review of abstracts and full-text manuscripts, on data extraction, and on the quality of evidence. Results: Reviewers identified 5,605 citations, and 12 articles met inclusion criteria. Only one of three case-control studies showed an association between stroke and MVC (OR 1.9, 95{\%} CI 1.0–3.9). Of five cohort reports, only one study, limited to self-report, found an increased risk of MVC associated with stroke or TIA (RR 2.71, 95{\%} CI 1.11–6.61). Two of four cross-sectional studies using computerized driving simulators identified a more than two-fold risk of MVCs among participants with stroke compared with controls. The difference in one of the studies was restricted to those with middle cerebral artery stroke. Conclusions: The evidence does not support a robust increase in risk of MVCs. While stroke clearly prevents some patients from driving at all and impairs driving performance in others, individualized assessment and clinical judgment must continue to be used in assessing and advising those stroke patients who return to driving about their MVC risk.",
keywords = "Accidents, automobile driving, ischemic attack, stroke, traffic, transient",
author = "Rapoport, {Mark J.} and Plonka, {Sarah C.} and Hillel Finestone and Mark Bayley and Chee, {Justin N.} and Brenda Vrkljan and Sjaan Koppel and Elizabeth Linkewich and Charlton, {Judith L.} and Shawn Marshall and Martin delCampo and Boulos, {Mark I.} and Swartz, {Richard H.} and Jaspreet Bhangu and Gustavo Saposnik and Jessica Comay and Jamie Dow and Debbie Ayotte and Desmond O’Neill",
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Rapoport, MJ, Plonka, SC, Finestone, H, Bayley, M, Chee, JN, Vrkljan, B, Koppel, S, Linkewich, E, Charlton, JL, Marshall, S, delCampo, M, Boulos, MI, Swartz, RH, Bhangu, J, Saposnik, G, Comay, J, Dow, J, Ayotte, D & O’Neill, D 2019, 'A systematic review of the risk of motor vehicle collision after stroke or transient ischemic attack' Topics in Stroke Rehabilitation, vol. 26, no. 3, pp. 226-235. https://doi.org/10.1080/10749357.2018.1558634

A systematic review of the risk of motor vehicle collision after stroke or transient ischemic attack. / Rapoport, Mark J.; Plonka, Sarah C.; Finestone, Hillel; Bayley, Mark; Chee, Justin N.; Vrkljan, Brenda; Koppel, Sjaan; Linkewich, Elizabeth; Charlton, Judith L.; Marshall, Shawn; delCampo, Martin; Boulos, Mark I.; Swartz, Richard H.; Bhangu, Jaspreet; Saposnik, Gustavo; Comay, Jessica; Dow, Jamie; Ayotte, Debbie; O’Neill, Desmond.

In: Topics in Stroke Rehabilitation, Vol. 26, No. 3, 03.04.2019, p. 226-235.

Research output: Contribution to journalReview ArticleResearchpeer-review

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T1 - A systematic review of the risk of motor vehicle collision after stroke or transient ischemic attack

AU - Rapoport, Mark J.

AU - Plonka, Sarah C.

AU - Finestone, Hillel

AU - Bayley, Mark

AU - Chee, Justin N.

AU - Vrkljan, Brenda

AU - Koppel, Sjaan

AU - Linkewich, Elizabeth

AU - Charlton, Judith L.

AU - Marshall, Shawn

AU - delCampo, Martin

AU - Boulos, Mark I.

AU - Swartz, Richard H.

AU - Bhangu, Jaspreet

AU - Saposnik, Gustavo

AU - Comay, Jessica

AU - Dow, Jamie

AU - Ayotte, Debbie

AU - O’Neill, Desmond

PY - 2019/4/3

Y1 - 2019/4/3

N2 - Background: Returning to driving after stroke is one of the key goals in stroke rehabilitation, and fitness to drive guidelines must be informed by evidence pertaining to risk of motor vehicle collision (MVC) in this population. Objectives: The purpose of the present study was to determine whether stroke and/or transient ischemic attack (TIA) are associated with an increased MVC risk. Methods: We searched MEDLINE, CINAHL, EMBASE, PsycINFO, and TRID through December 2016. Pairs of reviewers came to consensus on inclusion, based on an iterative review of abstracts and full-text manuscripts, on data extraction, and on the quality of evidence. Results: Reviewers identified 5,605 citations, and 12 articles met inclusion criteria. Only one of three case-control studies showed an association between stroke and MVC (OR 1.9, 95% CI 1.0–3.9). Of five cohort reports, only one study, limited to self-report, found an increased risk of MVC associated with stroke or TIA (RR 2.71, 95% CI 1.11–6.61). Two of four cross-sectional studies using computerized driving simulators identified a more than two-fold risk of MVCs among participants with stroke compared with controls. The difference in one of the studies was restricted to those with middle cerebral artery stroke. Conclusions: The evidence does not support a robust increase in risk of MVCs. While stroke clearly prevents some patients from driving at all and impairs driving performance in others, individualized assessment and clinical judgment must continue to be used in assessing and advising those stroke patients who return to driving about their MVC risk.

AB - Background: Returning to driving after stroke is one of the key goals in stroke rehabilitation, and fitness to drive guidelines must be informed by evidence pertaining to risk of motor vehicle collision (MVC) in this population. Objectives: The purpose of the present study was to determine whether stroke and/or transient ischemic attack (TIA) are associated with an increased MVC risk. Methods: We searched MEDLINE, CINAHL, EMBASE, PsycINFO, and TRID through December 2016. Pairs of reviewers came to consensus on inclusion, based on an iterative review of abstracts and full-text manuscripts, on data extraction, and on the quality of evidence. Results: Reviewers identified 5,605 citations, and 12 articles met inclusion criteria. Only one of three case-control studies showed an association between stroke and MVC (OR 1.9, 95% CI 1.0–3.9). Of five cohort reports, only one study, limited to self-report, found an increased risk of MVC associated with stroke or TIA (RR 2.71, 95% CI 1.11–6.61). Two of four cross-sectional studies using computerized driving simulators identified a more than two-fold risk of MVCs among participants with stroke compared with controls. The difference in one of the studies was restricted to those with middle cerebral artery stroke. Conclusions: The evidence does not support a robust increase in risk of MVCs. While stroke clearly prevents some patients from driving at all and impairs driving performance in others, individualized assessment and clinical judgment must continue to be used in assessing and advising those stroke patients who return to driving about their MVC risk.

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