Hyperglycaemia and the SOAR stroke score in predicting mortality

Background: We assessed the association between admission blood glucose levels and acute stroke mortality and examined if there was any incremental value of adding glucose status to the validated acute stroke mortality predictor - the SOAR score. Methods: Data from Norfolk and Norwich University Hospital Stroke & TIA register (20032013) and Anglia Stroke Clinical Network Evaluation Study (2009-2012) were analysed. Multivariable analysis assessed the association between admission blood glucose levels with inpatient and 7-day mortality. The prognostic ability of the SOAR score was then compared with the SOAR with glucose score(SOAR-G). Results: A total of 5,575 acute stroke patients(ischaemic stroke 89.2%), with mean age(sd) of 76.97±11.88 years were included. Both borderline hyperglycaemia (7.9-11.0mmol/L) and hyperglycaemia (>11.0mmol/L) when compared to normoglycaemia (4.0-7.8mmol/L), were associated with both 7-day and inpatient mortality after controlling for sex, age, OCSP classification and pre-stroke modified Rankin score. Both the SOAR stroke score and SOAR G were good predictors of inpatient stroke mortality [AUC 0.82(95%CI:0.81-0.84) and 0.83(95%CI:0.81-0.84)], respectively. These scores were also good at predicting outcomes in both patients with and without diabetes. Conclusions: High blood glucose levels at admission were associated with worse acute stroke mortality outcomes. The constituents of the SOAR stroke score were good at predicting mortality after stroke.