Date Published: July 6, 2017
Publisher: Public Library of Science
Author(s): Hui Wang, Yuesong Pan, Xia Meng, Chunjuan Wang, Xiaoling Liao, David Wang, Xingquan Zhao, Liping Liu, Hao Li, Yilong Wang, Yongjun Wang, Xiaoying Wang.
It is unclear in Chinese patients with acute stroke how the SOAR (stroke subtype, Oxfordshire Community Stroke Project classification, age, and prestrike modified Rankin) and mSOAR (modified-SOAR) scores performed in predicting discharge mortality and 3-month mortality. We aimed to validate the predictability of these scores in this cohort.
Data from the China National Stroke Registry (CNSR) study was used to perform the mSOAR and SOAR scores for predicting the discharge and 3-month mortality in acute stroke patients.
A total of 11073 acute stroke patients were included in present study. The increased mSOAR and SOAR scores were closely related to higher death risk in acute stroke patients. For discharge mortality, the area under the receiver-operator curve (AUC) of the mSOAR and SOAR scores were 0.784 (95% CI 0.761–0.807) and 0.722 (95% CI: 0.698–0.746). For 3-month mortality, they were 0.787 (95% CI: 0.771–0.803) and 0.704 (95% CI: 0.687–0.721), respectively. The mSOAR and SOAR scores showed significant correlation between the predicted and observed probabilities of discharge mortality (mSOAR: r = 0.945, P = 0.001; SOAR: r = 0.994, P<0.001) and 3-month mortality (mSOAR: r = 0.984, P<0.001; SOAR: r = 0.999; P<0.001). The mSOAR score predicted reliably the risk of death in Chinese acute stroke patients.
Stroke has been the second leading cause of death and acquired adult disability worldwide . Therefore, the mortality of acute stroke patients is an important endpoint in clinical practice [2–4]. It closely related with agedness, higher neurological severity score and symptomatic intracranial hemorrhage (sICH) [5, 6]. The models were used for predicting the mortality and clinical benefit, which could help clinicians to decide the individual treatments and to inform patients and relatives. In fact, several models have been used to predict clinical functional outcome and risk of sICH in acute stroke patients [7–9], especially the factors associated with stroke mortality have been explored various prognostic models. However, they usually included multiple variables, such as plasma glucose levels and cerebral hematoma volume, which varied with time and not easily obtained. Therefore, a simple and reliable clinical prognostic tool to predict stroke mortality was useful.
In this multicenter registry study of 11073 patients, the mSOAR and SOAR score showed a well prediction of discharge and 3-month mortality of acute stroke patients, especially by the mSOAR score.
Our study demonstrated that the mSOAR score has a good ability for predicting the discharge mortality and 3-month mortality in Chinese patients with acute stroke. The mSOAR score is a reliable and easy to use clinical instrument to predict mortality in acute stroke patients.