mSOAR: an effective bedside stroke prognosis tool

Abstract

The modified-SOAR (mSOAR) score is composed of the stroke subtype, Oxfordshire Community Stroke Project classification, age, pre-stroke modified Rankin score (mRS) and the National Institutes of Health Stroke Scale score. It has previously been shown to be a reliable predictor of mortality and length of -hospital stay. This study sought to identify whether the mSOAR can also be used to predict patient disability on discharge. A post-hoc calculation of mSOAR using Sentinel Stroke National Audit Programme (SSNAP) data and electronic discharge -summaries was performed on all stroke admissions to Bridgend Hospital over an 11-month period. This study included 230 patients, of which 88% had suffered infarcts and 23% had experienced a previous cerebrovascular episode or transient ischaemic attack; 52% were female. The mortality rate was 13% and 57% had slight disability or less (mRS≤2) on discharge. Each increase in mSOAR score was associated with significantly worse discharge disability (p<0.05). We conclude that the mSOAR score is an excellent tool for predicting both discharge disability and mortality. As such, it's useful for admission prognosis discussions with patients, their relatives and the multidisciplinary team and for early supported discharge decision making.

Keywords: Discharge disability; Rankin score; mSOAR; mortality; stroke prognosis.

Fig 1.

mSoar versus median discharge disability (mean values given). mRS = modified Rankin score; mSOAR = modified stroke subtype, Oxfordshire Community Stroke Project classification, age, pre-stroke modified Rankin score and the National Institutes of Health Stroke Scale score

Fig 2.

Comparison of discharge disability (mRS) by mSOAR grouping. mRS = modified Rankin score; mSOAR = modified stroke subtype, Oxfordshire Community Stroke Project classification, age, pre-stroke modified Rankin score and the National Institutes of Health Stroke Scale score