Addition of sodium criterion to SOAR stroke score

I. R. Adekunle-Olarinde, S. J. McCall, R. S. Barlas, A. D. Wood, A. B. Clark, J. H. Bettencourt-Silva, A. K. Metcalf, K. M. Bowles, R. L. Soiza, J. F. Potter, P. K. Myint

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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.
Original languageEnglish
Pages (from-to)553-559
Number of pages7
JournalActa Neurologica Scandinavica
Issue number5
Early online date10 Jul 2016
Publication statusPublished - May 2017

Bibliographical note

The NNUH Stroke and TIA Register is maintained by the NNUH NHS Foundation Trust Stroke Services and data management for this study is supported by the NNUH Research and Development Department through Research Capability Funds.


  • acute stroke
  • dysnatraemia
  • mortality
  • prognosis


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