Addition of sodium criterion to SOAR stroke score

Adekunle-Olarinde, Iyabo R.; McCall, Steve; Barlas, Raphae S.; Wood, Andy; Clark, Allan; Bettencourt‐Silva, Joao H.; Metcalf, Anthony K.; Bowles, Kristian M.; Soiza, Roy L.; Potter, John F.; Myint, Phyo Kyaw

doi:10.1111/ane.12634

Cited by 3 publications

(3 citation statements)

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“…For predicting length of hospital stay, dichotomized at seven days, AUROC was 0.61 (95%CI: 0.60–0.62). Although external validation was not included as part of the derivation paper, SOAR has been subsequently assessed in independent datasets in five studies (98–103). Four studies assessed the scale's performance for predicting early mortality (inpatient, 7-day, discharge, and 90-day).…”

Section: Resultsmentioning

confidence: 99%

“…Nonetheless, the finding was confirmed in an independent Chinese patient sample: AUROC of 0.78 (95%CI: 0.76–0.81) and 0.79 (95%CI: 0.77–0.80) for discharge and 90-day mortality, respectively, compared to 0.72 (95%CI: 0.70–0.75) and 0.70 (95%CI: 0.69–0.72), respectively, with higher estimates reported for mSOAR. The remaining two updates of SOAR included adding admission blood glucose levels (SOAR-G) and admission sodium (SOAR-Na) (101, 103). Both concluded that the original and revised scales performed well, however without evidence of the latter offering a significant improvement in discriminatory power.…”

Section: Resultsmentioning

confidence: 99%

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Thinking About the Future: A Review of Prognostic Scales Used in Acute Stroke

2019

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Background: There are many prognostic scales that aim to predict functional outcome following acute stroke. Despite considerable research interest, these scales have had limited impact in routine clinical practice. This may be due to perceived problems with internal validity (quality of research), as well as external validity (generalizability of results). We set out to collate information on exemplar stroke prognosis scales, giving particular attention to the scale content, derivation, and validation. Methods: We performed a focused literature search, designed to return high profile scales that use baseline clinical data to predict mortality or disability. We described prognostic utility and collated information on the content, development and validation of the tools. We critically appraised chosen scales based on the CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modeling Studies (CHARMS). Results: We chose 10 primary scales that met our inclusion criteria, six of which had revised/modified versions. Most primary scales used 5 input variables (range: 4–13), with substantial overlap in the variables included. All scales included age, eight included a measure of stroke severity, while five scales incorporated pre-stroke level of function (often using modified Rankin Scale), comorbidities and classification of stroke type. Through our critical appraisal, we found issues relating to excluding patients with missing data from derivation studies, and basing the selection of model variable on significance in univariable analysis (in both cases noted for six studies). We identified separate external validation studies for all primary scales but one, with a total of 60 validation studies. Conclusions: Most acute stroke prognosis scales use similar variables to predict long-term outcomes and most have reasonable prognostic accuracy. While not all published scales followed best practice in development, most have been subsequently validated. Lack of clinical uptake may relate more to practical application of scales rather than validity. Impact studies are now necessary to investigate clinical usefulness of existing scales.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Thinking About the Future: A Review of Prognostic Scales Used in Acute Stroke

2019

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“…F) Further adjusted for the acute illness parameters of the admission serum sodium, albumin, and glucose. 15 16 17 …”

Section: Mehtodsmentioning

confidence: 99%

A History of Falls is Associated with a Significant Increase in Acute Mortality in Women after Stroke

et al. 2017

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Background and PurposeThe risks of falls and fractures increase after stroke. Little is known about the prognostic significance of previous falls and fractures after stroke. This study examined whether having a history of either event is associated with poststroke mortality.MethodsWe analyzed stroke register data collected prospectively between 2003 and 2015. Eight sex-specific models were analyzed, to which the following variables were incrementally added to examine their potential confounding effects: age, type of stroke, Oxfordshire Community Stroke Project classification, previous comorbidities, frailty as indicated by the prestroke modified Rankin Scale score, and acute illness parameters. Logistic regression was applied to investigate in-hospital and 30-day mortality, and Cox proportional-hazards models were applied to investigate longer-term outcomes of mortality.ResultsIn total, 10,477 patients with stroke (86.1% ischemic) were included in the analysis. They were aged 77.7±11.9 years (mean±SD), and 52.2% were women. A history of falls was present in 8.6% of the men (n=430) and 20.2% of the women (n=1,105), while 3.8% (n=189) of the men and 12.9% of the women (n=706) had a history of both falls and fractures. Of the outcomes examined, a history of falls alone was associated with increased in-hospital mortality [odds ratio (OR)=1.33, 95% confidence interval (CI)=1.03–1.71] and 30-day mortality (OR=1.34, 95% CI=1.03–1.73) in women in the fully adjusted models. The Cox proportional-hazards models for longer-term outcomes and the history of falls and fractures combined showed no significant results.ConclusionsThe history of falls is an important factor for acute stroke mortality in women. A previous history of falls may therefore be an important factor to consider in the short-term stroke prognosis, particularly in women.

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