NIHSS Score May Help Predict Health Literacy Levels after Acute Ischemic Stroke (P7.158)

OBJECTIVE:The aim of this study was to determine if neurologic deficit induced by acute ischemic stroke (AIS) is associated with health literacy level. BACKGROUND: Minimizing risk of stroke recurrence is dependent on patient compliance with medication and risk factor management strategies. Health literacy (HL) contributes to patients’ comprehension of medical instructions and adherence to recommended treatment. The effect of acute stroke related biologic factors on HL levels has not been previously reported. DESIGN/METHODS: This was a hospital based, prospective cross-sectional study. Neurologic deficit was quantified by the National Institutes of Health Stroke Scale (NIHSS) and HL level was assessed by the Short Test of Functional Health Literacy in Adults (STOFHLA). The 36-point scale of the STOFHLA is divided into three categories of functional literacy: inadequate (0-16), adequate (17-22) and functional (23-36). Correlation between NIHSS and STOFHLA scores was assessed using Spearman9s correlation coefficient. RESULTS: Ninety-five patients with AIS verified by an imaging study were enrolled in the study. The average age of participants was 60 years (SD 12.4). A majority of the patients were male (57%), African-American (56%), and earned less than $25,000 per year (75%). The mean NIHSS was 3.3 (SD 2.9), and the mean STOFHLA score was 20.1. The mean STOFHLA score in patients with minor AIS deficits (NIHSS <4) was 21.7 compared to 16.9 in patients with moderate or severe deficits (p=0.08). There was a negative correlation between NIHSS scores and STOFHLA scores, but this did not reach statistical significance (r= -0.203; p=0.056). CONCLUSIONS: This study suggests that there may be an association between the NIHSS score and HL levels in patients hospitalized with AIS. Additional studies incorporating a larger number of patients are warranted to discern if this is a true association. Patient NIHSS score might be a factor healthcare professionals can utilize to help identify hospitalized AIS patients who require intensive stroke risk reduction education. Study Supported by:University of Florida COM - Jacksonville Dean9s Grant Disclosure: Dr. Sanders has received personal compensation for activities with Biogen Idec. Dr. Sanders has received research support from Biogen Idec and Novartis. Dr. Smotherman has nothing to disclose. Dr. Silliman has received personal compensation for activities with Biogen Idec, and Teva Neuroscience as a consultant and/or speaker. Dr. Silliman has received research support from Genzyme Corp., Biogen Idec, and Novartis.