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
Epidemiology Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.
Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Acta Neurol Scand. 2017 May;135(5):553-559. doi: 10.1111/ane.12634. Epub 2016 Jul 10.
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.
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 scores for mortality outcomes at both time points were then compared using the Area Under the Curve (AUC) values from the Receiver Operating Characteristic curves.
A total of 8493 cases were included (male=47.4%, mean (SD) 77.7 (11.6) years). Compared with normonatremia (135-145 mmol/L), hypernatraemia (>145 mmol/L) was associated with inpatient mortality and moderate (125-129 mmol/L) and severe hypontraemia (<125 mmol/L) with 7-day mortality after adjustment for stroke type, Oxfordshire Community Stroke Project classification, age, prestroke modified Rankin score and sex. The SOAR and SOAR-Na scores both performed well in predicting inpatient mortality with AUC values of .794 (.78-.81) and .796 (.78-.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.
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.
探讨将钠（Na）水平纳入SOAR卒中评分标准对预测卒中患者住院期间及7天死亡率的有效性。
分析了诺福克和诺维奇大学医院卒中与短暂性脑缺血发作登记处（2003 - 2015年）的数据。采用单变量模型，然后是控制SOAR变量的多变量模型，来评估入院时钠水平与住院期间及7天死亡率之间的关联。然后使用来自接受者操作特征曲线的曲线下面积（AUC）值，比较SOAR和SOAR-Na评分在两个时间点对死亡率结局的预测能力。
共纳入8493例病例（男性占47.4%，平均（标准差）77.7（11.6）岁）。与正常血钠水平（135 - 145 mmol/L）相比，高钠血症（>145 mmol/L）与住院死亡率相关，而中度（125 - 129 mmol/L）和重度低钠血症（<125 mmol/L）在调整卒中类型、牛津郡社区卒中项目分类、年龄、卒中前改良Rankin评分和性别后与7天死亡率相关。SOAR和SOAR-Na评分在预测住院死亡率方面表现良好，AUC值分别为0.794（0.78 - 0.81）和0.796（0.78 - 0.81）。7天死亡率显示出类似结果。在慢性肾脏病（CKD）患者中，这两种评分的预测能力均较差，而在低血糖患者中则更差。
SOAR-Na评分并不比SOAR卒中评分表现得显著更好。然而，SOAR-Na评分在CKD和血糖异常患者中的表现需要进一步研究。
