Addition of sodium criterion to SOAR stroke score

Adekunle-Olarinde, Iyabo R., McCall, Stephen J., Barlas, Raphae S., Wood, Adrian D., Clark, Allan B. ORCID:, Bettencourt-Silva, Joao H., Metcalf, Anthony K., Bowles, Kristian M. ORCID:, Soiza, Roy L., Potter, John F. and Myint, Phyo K. (2017) Addition of sodium criterion to SOAR stroke score. Acta Neurologica Scandinavica, 135 (5). 553–559. ISSN 0001-6314

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Objectives: To examine the usefulness of including sodium (Na) levels as a criterion to the SOAR stroke score in predicting inpatient and 7-day mortality in stroke.  Materials & Methods: Data from the Norfolk and Norwich University Hospital Stroke & TIA register (2003-2015) were analysed. Univariate and then multivariate models controlling for SOAR variables were used to assess the association between admission sodium levels and inpatient and 7-day mortality. The prognostic ability of the SOAR and SOAR-Na score for mortality outcomes at both time points were then compared using Area Under the Curve (AUC) values from Receiver Operating Characteristics.  Results: A total of 8,493 cases were included (male=47.4%, mean (s. d.) 77.7 (11.6) years). Compared to normonatraemia (135-145mmol/L), hypernatraemia (>145mmol/L) was associated with inpatient mortality and moderate (125-129mmol/L) and severe hypontraemia (<125mmol/L) with 7-day mortality after adjustment for stroke type, Oxfordshire Community Stroke Project classification, age, pre-stroke modified Rankin score and sex. The SOAR and SOAR-Na scores both performed well in predicting inpatient mortality with AUC values of 0.794(0.78-0.81) and 0.796(0.78-0.81), respectively. 7-day mortality showed similar results. Both scores were less predictive in those with chronic kidney disease (CKD) and more so in those with hypoglycaemia.  Conclusion: The SOAR-Na did not perform considerably better than the SOAR stroke score. However, the performance of SOAR-Na in those with CKD and dysglycaemias requires further investigation.

Item Type: Article
Uncontrolled Keywords: acute stroke,dysnatremia,mortality,prognosis
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: Pure Connector
Date Deposited: 21 Jun 2016 12:08
Last Modified: 22 Oct 2022 01:17
DOI: 10.1111/ane.12634

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