mSOAR评分对急性缺血性卒中患者不良预后风险预测价值的探讨

Validation of mSORE score for predicting poor outcome in acute ischemic stroke

目的:探讨改良SOAR(Stroke subtype,Oxfordshire community stroke project classification,Age and prestroke modified rankin,m SOAR)评分对我国急性缺血性卒中(acute ischemic stroke,AIS)患者出院时发生不良预后事件的预测价值。方法:分析2014年10月至2017年12月公利医院神经内科和急诊科收治的AIS患者1 461例,记录年龄、性别、牛津郡社区卒中项目(Oxfordshire community stroke project,OCSP)分型、卒中前改良Rankin量表(modified Rankin Scale,m RS)评分和美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分等信息,并于入院时使用m SOAR量表进行评分。所有患者出院时均行m RS评分,以出院时出现死亡或重度残疾(m RS≥4分)作为不良预后事件。结果:出院时382例(26.1%)患者出现不良预后事件。在m SOAR评分1~6分之间,每增加1分,患者出院时存在残疾的风险都会有显著增加(P<0.001),出院时不良预后风险在m SOAR评分0~3分组与4~8分组之间差异有统计学意义(P<0.001)。m SOAR评分预测患者出院时不良预后风险时的受试者工作特征(receiver operating characteristic curve,ROC)曲线下面积(area under curve,AUC)为0.868(95%CI为0.844~0.891)。结论:m SOAR量表对我国AIS患者出院时发生不良预后事件的风险预测能力较强。

Objective： To explore the value of m SOAR score for predicting the occurrence of adverse prognostic events at discharge in patients with acute ischemic stroke（AIS）. Methods： From October 2014 to December 2017, a total of 1 461 AIS patients hospitalized in Neurology Department and Emergency Department of our hospital were enrolled.Related baseline data including age, gender were recorded and Oxfordshire Community Stroke Project（OCSP） classification, pre-stroke modified Rankin scale（m RS） score, and National Institute of Health Stroke Scale（NIHSS） score as well as the m SOAR score were assessed at admission. The adverse prognostic events were defined as death or poor functional outcome with modified Rankin Scale（≥4） when patients were discharged. Results： Of all the subjects, 382 cases（26.1%）had adverse prognostic events at discharge. Between points 1-6, a one-point increase in m SOAR score resulted in a significant increase in risk of poor prognosis at discharge（P〈 0.001）, and the risk of poor prognosis at discharge between 0-3 and 4-8 in m SOAR score was significantly different（P〈 0.001）. The risk of poor prognosis at discharge was predicted and the AUC value for the m SOAR score was 0.868（95% CI 0.844-0.891）. Conclusions： m SOAR score has a strong ability for predicting the risk of adverse prognostic events at discharge in patients with acute ischemic stroke.