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Modified SOAR Score for Stroke

Calculators  Neurology
Modified SOAR score is predictive tool used to estimate the short-term mortality in patients suffering from stroke
Stroke type
Infarct 0
Hemorrhage 1
Oxfordshire community stroke project classification
LACS = lacunar circulation stroke, PACS = partial anterior circulation stroke, POCS = posterior circulation stroke, TACS = total anterior circulation stroke
LACS/PACS 0
POCS 1
TACS 2
Age
<=65 0
66-85 1
>85 2
Pre-stroke disability
0-2 0
3-4 1
5 2
NIHHS score
0-4 0
5-10 1
>=11 2
Result:

Background

Measured Factor
Short term mortality in stroke patients
Measured Factor Disease
  • Stroke
Measured Factor Detail
Modified SOAR score is a prognosis tool used to estimate the short term mortality in stroke inpatients. It takes into accouint 5 varibales which include stroke type, age, stroke severity (NIHSS score), Premorbid functional status and Oxfordshire community stroke project (OCSP) classification.
Speciality
Neurologist
Body System
Neurology
Measured Factor Low Impact
  • mSCORE 0 indicates 1% inpatient mortality
Measured Factor High Impact
  • A maximum score of 7 indicates inpatient mortality of 49.2%

Result Interpretation

Ranges Ranges
  • Critical High: 700%
Result High Conditions
  • Mortality
Test Limitations
Does not apply to patients with transient ischemic attack, subarachnoid hemorrhage, or subdural hemorrhage.
References: 2

Studies

Study Validation 1
his study was conducted in order to evaluate the reliability of the modified-SOAR (mSOAR) score in predicting patient disability on discharge.  A total of 230 patients were involved in the study and a post post-hoc calculation of mSOAR was calculated using Sentinel Stroke National Audit Programme (SSNAP) data. The mortality rate was 13% and disability was found to be in 57% patients on discharge. With increasing mSOAR score disability on discharge also got worsen significantly. This study concluded that mSOAR score is a great tool in predicting both discharge disability and mortality and can aid in for early discharge decision making.
References: 3
Study Validation 2
The aim of this study was to determine the improvement in modified Rankin (SOAR) score after including a measure of initial stroke severity (NIHSS). Performance of both SOAR and mSOAR using an independent cohort data was evaluated. A total of 1002 and 1012 patients with stroke were involved in the derivation cohort and validation cohort respectively. In derivation cohort early mortality obtained from the SOAR and mSOAR scores were 0.79 (95% confidence interval, 0.75-0.84) and 0.83 (95% confidence interval, 0.79-0.86), respectively. In validation cohort mortality obtained from the mSOAR scores were 3% to 42%. This study concluded that 
With addition of NIHSS data prognostic utility was improved with modified-SOAR score. mSOAR score have better clinical utility in predicting early mortality in stroke patients.
References: 4
Study Validation 3
The aim of this study was to validate a stroke prognostic scoring system in predicting early mortality and hospital length of stay. Retrospective data from 12,355 patients with stroke was analyzed. An 8 point score was assessed based on multiple logistic regression model. Patient related factors included age, gender, stroke subtype, clinical classification, and prestroke disability. The outcome measures were in-patient and seven-day mortality. Results showed area under the curve values of 0.79 for in-hospital and seven-day mortality and higher score indicated longer stay than in low score with shorter median length stay. This study analysis revealed that this 8 point clinical score is great predictor of acute stroke mortality and length of hospital stay. This prognostic tool can be utilized in providing better service to risk stratify patients with stroke.
References: 2
Study Additional 1
This study aimed to validate the SOAR and mSOAR in Chinese patients with acute stroke. Discharge mortality and 3-month mortality were the predictors of both the scores. A total 11,073 with acute stroke were recruited in the study. A comparison between SOAR and mSOAR were drawn out by statistical methods. Results showed that with increasing mSOAR and SOAR scores the chance of death risk also increased. . The mSOAR and SOAR scores showed significant association between the predicted and observed probabilities of discharge mortality. Study concluded that mSOAR had a better reliability in predicting the risk of death in Chinese patients with acute stroke.
References: 5
Study Additional 2
This study aimed at validates the Rankin stroke score, Oxfordshire Community Stroke Project Classification (OCSPC), in predicting inpatient and 7-day mortality from 2008 to 2011 year. A total of 3547 stroke patients (ischemic, 92%) were involved in the study. Results showed that with increasing stroke subtype there was also increment in OCSPC and prestroke Rankin stroke score. Area under the receiver operator curves values for inpatient and 7-day mortality were found to be 0.80 and 0.82, respectively. This study concluded that these score may help in predicting early stroke in various stroke patients.
References: 6

References

  1. Myint PK, Clark AB, Kwok CS, Davis J, Durairaj R, Dixit AK et al. The SOAR (Stroke subtype, Oxford Community Stroke Project classification, Age, prestroke modified Rankin) score strongly predicts early outcomes in acute stroke. Int J Stroke. 2014;9(3):278-83.
  2. Myint PK, Clark AB, Kwok CS, Davis J, Durairaj R, Dixit AK, et al. The SOAR (Stroke subtype, Oxford Community Stroke Project classification, Age, prestroke modified Rankin) score strongly predicts early outcomes in acute stroke. Int J Stroke. 2014;9(3):278-83.
  3. Thaller M, Mitchell N. mSOAR: an effective bedside stroke prognosis tool. Clin Med (Lond). 2017;17(3):204-208.
  4. Abdul-rahim AH, Quinn TJ, Alder S, Clark AB, Musgrave SD, Langhorne P, et al. Derivation and Validation of a Novel Prognostic Scale (Modified-Stroke Subtype, Oxfordshire Community Stroke Project Classification, Age, and Prestroke Modified Rankin) to Predict Early Mortality in Acute Stroke. Stroke. 2016;47(1):74-9.
  5. Wang H, Pan Y, Meng X, Wang C, Liao X, Wang D, et al. Validation of the mSOAR and SOAR scores to predict early mortality in Chinese acute stroke patients. PLoS ONE. 2017;12(7):e0180444.
  6. Kwok CS, Potter JF, Dalton G, George A, Metcalf AK, Ngeh J, et al. The SOAR stroke score predicts inpatient and 7-day mortality in acute stroke. Stroke. 2013;44(7):2010-2.