The Cardiovascular
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Modified SOAR Score for Stroke

Predicts early in-hospital mortality after acute stroke using subtype, OCSP classification, age, pre-stroke disability, and NIHSS.

Modified SOAR Score for Stroke
Stroke subtype
Oxford Community Stroke Project (OCSP) classification
Age
Pre-stroke modified Rankin Scale (mRS)
Admission NIHSS score
Result0 points

Higher scores predict progressively higher early in-hospital mortality; scores in the upper range (>=6) are associated with a substantially increased risk of death.

Modified SOAR score
0

When to use

  • Estimating early (in-hospital/7-day) mortality risk after acute stroke to inform prognosis discussions and triage.

Formula

Modified SOAR = Stroke subtype (0-1) + OCSP classification (0-2) + Age (0-2) + pre-stroke mRS (0-2) + admission NIHSS (0-2). Range 0-9; adds NIHSS to the original SOAR score.

Pearls and pitfalls

  • The original SOAR score (0-7, without NIHSS) showed crude in-hospital mortality rising from about 1.6% at a score of 0 to over 60% at a score of 6.
  • Should support, not replace, individualized clinical prognostication.

References

  1. Myint PK, Clark AB, Kwok CS, et al. Int J Stroke. 2014;9(3):278-83 (original SOAR score).