目的：探讨改良SOAR（Stroke subtype, Oxfordshire community stroke project classification, Age and prestroke modified rankin, mSOAR）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,mRS）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mSOAR量表进行评分。所有患者出院时均行mRS评分,以出院时出现死亡或重度残疾（mRS≥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mSOAR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mSOAR评分 0~3分组与4~8分组之间差异有统计学意义（P<0.001）。mSOAR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：mSOAR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 mSOAR 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 (mRS) score, and National Institute of Health Stroke Scale (NIHSS) score as well as the mSOAR 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 mSOAR score resulted in a signi-ficant 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 mSOAR score was significantly different (P<0.001). The risk of poor prognosis at discharge was predicted and the AUC value for the mSOAR score was 0.868 (95% CI 0.844-0.891). Conclusions: mSOAR score has a strong ability for predicting the risk of adverse prognostic events at discharge in patients with acute ischemic stroke.
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