Azmil H Abdul-Rahim1, Terence J Quinn2, Sarah Alder2, Allan B Clark2, Stanley D Musgrave2, Peter Langhorne2, John F Potter2, Phyo Kyaw Myint2. 1. From the Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (A.H.A.-R., T.J.Q., P.L.); Aberdeen Royal Infirmary, NHS Grampian, Aberdeen, United Kingdom (S.A.); Norwich Medical School, University of East Anglia, Norfolk, United Kingdom (A.B.C., S.D.M., J.F.P.); and Epidemiology Group, School of Medicine and Dentistry, University of Aberdeen, Aberdeen, United Kingdom (P.K.M.). Azmil.Abdul-Rahim@glasgow.ac.uk. 2. From the Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (A.H.A.-R., T.J.Q., P.L.); Aberdeen Royal Infirmary, NHS Grampian, Aberdeen, United Kingdom (S.A.); Norwich Medical School, University of East Anglia, Norfolk, United Kingdom (A.B.C., S.D.M., J.F.P.); and Epidemiology Group, School of Medicine and Dentistry, University of Aberdeen, Aberdeen, United Kingdom (P.K.M.).
Abstract
BACKGROUND AND PURPOSE: The stroke subtype, Oxfordshire Community Stroke Project classification, age, and prestroke modified Rankin (SOAR) score is a prognostic scale proposed for early mortality prediction after acute stroke. We aimed to evaluate whether including a measure of initial stroke severity (National Institutes of Health Stroke Scale and modified-SOAR [mSOAR] scores) would improve the prognostic accuracy. METHODS: Using Anglia Stroke and Heart Clinical Network data, 2008 to 2011, we assessed the performance of SOAR and mSOAR against in-hospital mortality using area under the receiver operating curve statistics. We externally validated the prognostic utility of SOAR and mSOAR using an independent cohort data set from Glasgow. We described calibration using Hosmer-Lemeshow goodness-of-fit test. RESULTS: A total of 1002 patients were included in the derivation cohort, and 105 (10.5%) died as inpatients. The area under the receiver operating curves for outcome of early mortality derived 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 (P=0.001). The external validation data set contained 1012 patients with stroke; of which, 121 (12.0%) patients died within 90 days. The mSOAR scores identified the risk of early mortality ranging from 3% to 42%. External validation of mSOAR score yielded an area under the receiver operating curve of 0.84 (95% confidence interval, 0.82-0.88) for outcome of early mortality. Calibration was good (P=0.70 for the Hosmer-Lemeshow test). CONCLUSIONS: Adding National Institutes of Health Stroke Scale data to create a modified-SOAR score improved prognostic utility in both derivation and validation data sets. The mSOAR may have clinical utility by using easily available data to predict mortality.
BACKGROUND AND PURPOSE: The stroke subtype, Oxfordshire Community Stroke Project classification, age, and prestroke modified Rankin (SOAR) score is a prognostic scale proposed for early mortality prediction after acute stroke. We aimed to evaluate whether including a measure of initial stroke severity (National Institutes of Health Stroke Scale and modified-SOAR [mSOAR] scores) would improve the prognostic accuracy. METHODS: Using Anglia Stroke and Heart Clinical Network data, 2008 to 2011, we assessed the performance of SOAR and mSOAR against in-hospital mortality using area under the receiver operating curve statistics. We externally validated the prognostic utility of SOAR and mSOAR using an independent cohort data set from Glasgow. We described calibration using Hosmer-Lemeshow goodness-of-fit test. RESULTS: A total of 1002 patients were included in the derivation cohort, and 105 (10.5%) died as inpatients. The area under the receiver operating curves for outcome of early mortality derived 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 (P=0.001). The external validation data set contained 1012 patients with stroke; of which, 121 (12.0%) patients died within 90 days. The mSOAR scores identified the risk of early mortality ranging from 3% to 42%. External validation of mSOAR score yielded an area under the receiver operating curve of 0.84 (95% confidence interval, 0.82-0.88) for outcome of early mortality. Calibration was good (P=0.70 for the Hosmer-Lemeshow test). CONCLUSIONS: Adding National Institutes of Health Stroke Scale data to create a modified-SOAR score improved prognostic utility in both derivation and validation data sets. The mSOAR may have clinical utility by using easily available data to predict mortality.
Authors: Jane M Maguire; Steve Bevan; Tara M Stanne; Erik Lorenzen; Israel Fernandez-Cadenas; Graeme J Hankey; Jordi Jimenez-Conde; Katarina Jood; Jin-Moo Lee; Robin Lemmens; Christopher Levi; Bo Norrving; Kristiina Rannikmae; Natalia Rost; Jonathan Rosand; Peter M Rothwell; Rodney Scott; Daniel Strbian; Jonathan Sturm; Cathie Sudlow; Matthew Traylor; Vincent Thijs; Turgut Tatlisumak; Tadeusz Wieloch; Daniel Woo; Bradford B Worrall; Christina Jern; Arne Lindgren Journal: Eur Stroke J Date: 2017-04-19
Authors: Terence J Quinn; Martin Taylor-Rowan; Aishah Coyte; Allan B Clark; Stanley D Musgrave; Anthony K Metcalf; Diana J Day; Max O Bachmann; Elizabeth A Warburton; John F Potter; Phyo Kyaw Myint Journal: Front Neurol Date: 2017-06-13 Impact factor: 4.003
Authors: Antonio Di Carlo; Maria Lamassa; Marco Franceschini; Francesca Bovis; Lorenzo Cecconi; Sanaz Pournajaf; Stefano Paravati; Annibale Biggeri; Domenico Inzitari; Salvatore Ferro Journal: PLoS One Date: 2018-03-23 Impact factor: 3.240
Authors: Phyo Kyaw Myint; Shubin Sheng; Ying Xian; Roland A Matsouaka; Mathew J Reeves; Jeffrey L Saver; Deepak L Bhatt; Gregg C Fonarow; Lee H Schwamm; Eric E Smith Journal: J Am Heart Assoc Date: 2018-09-18 Impact factor: 5.501