title: Long-term prediction of functional outcome after stroke using single items of the Barthel Index at discharge from rehabilitation centre.
abstract: OBJECTIVE
  To determine the prognostic value of single items of the Barthel Index (BI) at discharge from rehabilitation, in predicting independence in personal activities of daily living (ADL) (BI score ≥ 95/100) at five years after stroke.
  
  
  METHODS
  People with stroke were recruited consecutively from four European rehabilitation centres. BI was assessed on discharge and at five years after stroke. Stepwise multivariate logistic regression analysis was used to determine independent predictors of BI score ≥ 95/100 at five years after stroke. Thereupon, percentage chance of reaching BI ≥ 95/100 at five years after stroke was calculated.
  
  
  RESULTS
  Data were available for 153 patients. Independence in dressing (odds ratio (OR)=5.22, 95% confidence interval (CI)=1.85-14.76, p=0.002) and bathing (OR=8.10, 95% CI=3.40-19.32, p<0.0001) were independent predictors. Independence in both items resulted in 74.1% (57.6-85.8) chance of reaching BI ≥ 95/100 at five years after stroke. Dependence in both items resulted in 6.3% (5.1-7.9) chance. Independence in bathing, but dependence in dressing resulted in 35.4% (30.7-40.4) chance whereas the opposite resulted in 26.1% (20.7-32.3) chance.
  
  
  CONCLUSIONS
  Simple assessment of dressing and bathing on discharge from rehabilitation enables therapeutic staff to predict prognosis for long-term independence in personal ADL. This method can be used for early identification of persons with stroke who need intensive follow-up. Implications for Rehabilitation (In)dependence for dressing and bathing at discharge from a rehabilitation centre are significant factors in the prediction of (in)dependence in personal ADL at five years after stroke. This predictive tool can be used for targeting inpatient stroke rehabilitation and early identification of those patients who need intensive follow-up.
authors.affiliation: Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Katholieke Universiteit Leuven , Leuven , Belgium .
authors.forename: Liesbet
authors.initials: L
authors.lastname: De Wit
authors.forename: Koen
authors.initials: K
authors.lastname: Putman
authors.forename: Hannes
authors.initials: H
authors.lastname: Devos
authors.forename: Nadine
authors.initials: N
authors.lastname: Brinkmann
authors.forename: Eddy
authors.initials: E
authors.lastname: Dejaeger
authors.forename: Willy
authors.initials: W
authors.lastname: De Weerdt
authors.forename: Walter
authors.initials: W
authors.lastname: Jenni
authors.forename: Nadina
authors.initials: N
authors.lastname: Lincoln
authors.forename: Birgit
authors.initials: B
authors.lastname: Schuback
authors.forename: Wilfried
authors.initials: W
authors.lastname: Schupp
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005060:Europe; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D063886:Patient Discharge Summaries / Q000706:statistics & numerical data; D011379:Prognosis; D057216:Propensity Score; D012047:Rehabilitation Centers / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D013997:Time Factors; D016896:Treatment Outcome