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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Abstract

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
Volume135
Issue number5
Early online date10 Jul 2016
DOIs
Publication statusPublished - May 2017

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Sodium
Stroke
Mortality
Inpatients
Chronic Renal Insufficiency
Area Under Curve
Hypernatremia
Hypoglycemia
ROC Curve

Keywords

  • acute stroke
  • dysnatraemia
  • mortality
  • prognosis

Cite this

Adekunle-Olarinde, I. R., McCall, S. J., Barlas, R. S., Wood, A. D., Clark, A. B., Bettencourt-Silva, J. H., ... Myint, P. K. (2017). Addition of sodium criterion to SOAR stroke score. Acta Neurologica Scandinavica, 135(5), 553-559. https://doi.org/10.1111/ane.12634

Addition of sodium criterion to SOAR stroke score. / Adekunle-Olarinde, I. R.; McCall, S. J.; Barlas, R. S.; Wood, A. D.; Clark, A. B.; Bettencourt-Silva, J. H.; Metcalf, A. K.; Bowles, K. M.; Soiza, R. L.; Potter, J. F.; Myint, P. K.

In: Acta Neurologica Scandinavica, Vol. 135, No. 5, 05.2017, p. 553-559.

Research output: Contribution to journalArticle

Adekunle-Olarinde, IR, McCall, SJ, Barlas, RS, Wood, AD, Clark, AB, Bettencourt-Silva, JH, Metcalf, AK, Bowles, KM, Soiza, RL, Potter, JF & Myint, PK 2017, 'Addition of sodium criterion to SOAR stroke score', Acta Neurologica Scandinavica, vol. 135, no. 5, pp. 553-559. https://doi.org/10.1111/ane.12634
Adekunle-Olarinde IR, McCall SJ, Barlas RS, Wood AD, Clark AB, Bettencourt-Silva JH et al. Addition of sodium criterion to SOAR stroke score. Acta Neurologica Scandinavica. 2017 May;135(5):553-559. https://doi.org/10.1111/ane.12634
Adekunle-Olarinde, I. R. ; McCall, S. J. ; Barlas, R. S. ; Wood, A. D. ; Clark, A. B. ; Bettencourt-Silva, J. H. ; Metcalf, A. K. ; Bowles, K. M. ; Soiza, R. L. ; Potter, J. F. ; Myint, P. K. / Addition of sodium criterion to SOAR stroke score. In: Acta Neurologica Scandinavica. 2017 ; Vol. 135, No. 5. pp. 553-559.
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abstract = "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 andinpatient 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.",
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TY - JOUR

T1 - Addition of sodium criterion to SOAR stroke score

AU - Adekunle-Olarinde, I. R.

AU - McCall, S. J.

AU - Barlas, R. S.

AU - Wood, A. D.

AU - Clark, A. B.

AU - Bettencourt-Silva, J. H.

AU - Metcalf, A. K.

AU - Bowles, K. M.

AU - Soiza, R. L.

AU - Potter, J. F.

AU - Myint, P. K.

N1 - Funding 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.

PY - 2017/5

Y1 - 2017/5

N2 - 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 andinpatient 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.

AB - 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 andinpatient 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.

KW - acute stroke

KW - dysnatraemia

KW - mortality

KW - prognosis

U2 - 10.1111/ane.12634

DO - 10.1111/ane.12634

M3 - Article

VL - 135

SP - 553

EP - 559

JO - Acta Neurologica Scandinavica

JF - Acta Neurologica Scandinavica

SN - 0001-6314

IS - 5

ER -