http://informahealthcare.com/dre ISSN 0963-8288 print/ISSN 1464-5165 online Disabil Rehabil, Early Online: 1–9 ! 2014 Informa UK Ltd. DOI: 10.3109/09638288.2014.948137 RESEARCH PAPER Predicting sickness impact profile at six months after stroke: further results from the European multi-center CERISE study C. Stummer 1 , G. Verheyden 1 *, K. Putman 2 , W. Jenni 3 , W. Schupp 4 , and L. De Wit 2 1 Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium, 2 Department of Medical Sociology, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussel, Belgium, 3 Rehaklinik Rheinfelden, Rheinfelden, Switzerland, and 4 Department of Neurologie/Neuropsychologie, Fachklinik, Herzogenaurach, Germany Abstract Purpose: To develop prognostic models and equations for predicting participation at six months after stroke. Methods: This European prospective cohort study recruited 532 consecutive patients from four rehabilitation centers. Participation was assessed at six months after stroke with the Sickness Impact Profile (SIP), which consists of a physical, psychosocial and independent dimension. Twenty-six independent variables on admission to the rehabilitation center and 13 additional variables measured at two months post stroke were included in the analysis. A multiple logistic regression analysis was conducted predicting good participation (SIP520%). Sensitivity, specificity, positive and negative predictive values were calculated. Results: The prognostic models for the three dimensions provided independent predictors containing demographics, complications, diagnostic, and disability measures. Sensitivity ranged from 64–84%, specificity 66–85%, positive predictive value 70–78%, and negative predictive value 76–87%. Barthel Index on admission, Euroqol Health State at two months and Caregiver Strain Index at two months were retained in all prediction models. Conclusions: A combination of variables was found in the prognostic models of the three dimensions of the SIP at six months after stroke. Already from the early beginning of stroke rehabilitation it seems important to focus on personal activities of daily living as well as caregivers’ strain. ä Implications for Rehabilitation  Prognostic factors predicting participation, measured by the three dimensions of the Sickness Impact Profile at six months post stroke include demographic variables, post-stroke complications, diagnostic parameters and disability measures.  Significant prognostic variables for all three dimensions of the Sickness Impact Profile were a higher Barthel Index score on admission to the rehabilitation center, a higher Euroqol Health State score at two months post stroke and a lower Caregiver Strain Index score at two months post stroke.  Early stroke therapy should therefore further emphasize rehabilitation of personal activities of daily living such as mobility, walking, feeding, dressing, and toilet use, as well as considering strategies to reduce caregiver strain such as giving support, providing information and training carers. Keywords Barthel index, prediction, prognosis, sickness impact profile, stroke History Received 27 October 2013 Revised 17 July 2014 Accepted 21 July 2014 Published online 29 August 2014 Introduction When a person after stroke is admitted to a rehabilitation center, it is important to inform patient, family and carers about therapy planning and the achievable level of functional recovery [1,2]. Predicting outcome is part of optimized stroke management in order to set relevant and realistic therapy goals [2]. According to the domains of the International Classification of Functioning, Disability and Health (ICF), there are different levels of predicting rehabilitation outcome post stroke [3]. Most studies focus on predicting the activity level, as demonstrated by a recent systematic review of Veerbeek et al. [2], which included 48 studies. They reported that the most frequently retained prognostic factors of outcome in activities of daily living (ADL) of 6 high-quality studies [4–9] were age [4–6,8,9], and National Institute of Health Stroke Scale score (NIHSS) on admission to the acute hospital [5,7–9]. The above-mentioned studies reported prognostic factors, but did not present an applicable prediction equation. Prediction equations enable the multidisciplinary team to provide individual stroke predictions. Literature shows that there is only one study [10] that provides a prediction equation to *Joint first author Address for correspondence: Dr. Liesbet de Wit, Department of Medical Sociology, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussel, Belgium. Tel: +32-2-4774767. E-mail: liesbet.de.wit@vub.ac.be Disabil Rehabil Downloaded from informahealthcare.com by Radboud Universiteit Nijmegen on 08/31/14 For personal use only.