SOAR Score for Early Stroke Mortality (Stroke subtype, Oxfordshire classification, Age, pre-stroke Rankin)
Simple 4-variable score (stroke subtype, OCSP classification, age, pre-stroke modified Rankin) predicting in-hospital and 7-day mortality after acute stroke from admission data (Myint 2014; validated by Kwok 2013).
Score interpretation
Crude in-hospital mortality 1.6 % at SOAR 0 in the derivation cohort (12,355 patients).
→ Standard stroke unit care; SOAR is a prognostic aid only.
Crude in-hospital mortality 4.0 % at SOAR 1 in the derivation cohort (12,355 patients).
→ Standard stroke unit care; SOAR is a prognostic aid only.
Crude in-hospital mortality 10.7 % at SOAR 2 in the derivation cohort (12,355 patients).
→ Standard stroke unit care; consider discussing prognosis with the patient and family (Kwok 2013 used SOAR ≥ 3 as the high-risk cut-off).
Crude in-hospital mortality 21.4 % at SOAR 3 in the derivation cohort (12,355 patients).
→ Standard stroke unit care; consider discussing prognosis with the patient and family (Kwok 2013 used SOAR ≥ 3 as the high-risk cut-off).
Crude in-hospital mortality 46.6 % at SOAR 4 in the derivation cohort (12,355 patients).
→ Discuss prognosis and goals of care early with the patient (if able) and family; the score informs but does not decide treatment — eligibility for acute reperfusion is assessed separately.
Crude in-hospital mortality 62.7 % at SOAR 5 in the derivation cohort (12,355 patients).
→ Discuss prognosis and goals of care early with the patient (if able) and family; the score informs but does not decide treatment — eligibility for acute reperfusion is assessed separately.
Crude in-hospital mortality 75.8 % at SOAR 6 in the derivation cohort (7 not reported).
→ Discuss prognosis and goals of care early with the patient (if able) and family; the score informs but does not decide treatment — eligibility for acute reperfusion is assessed separately.
Interpretation bands for the SOAR Stroke Score. Apply clinical judgement and local guidance.
References
- Myint PK, et al. The SOAR (Stroke subtype, Oxford Community Stroke Project classification, Age, prestroke modified Rankin) score strongly predicts early outcomes in acute stroke. Int J Stroke. 2014;9(3):278–283.
- Kwok CS, et al. The SOAR stroke score predicts inpatient and 7-day mortality in acute stroke. Stroke. 2013;44(7):2010–2012.
- NICE NG128. Stroke and transient ischaemic attack in over 16s: diagnosis and initial management. NICE. 2019 (updated 2023).
Related
Curated clinical cross-links plus same-class fallbacks.
- Aspirin (Loading Dose) · Antiplatelet — ACS / Ischaemic Stroke
- Alteplase (tPA) · Thrombolytic — Ischaemic Stroke / Massive PE
- Edoxaban (AF Stroke Prevention / VTE) · Direct Factor Xa Inhibitor (DOAC)
- Clopidogrel (Stroke/TIA Secondary Prevention) · Antiplatelet (P2Y12 Inhibitor)
- Dabigatran (Stroke Prevention — AF) · Direct Oral Anticoagulant — Thrombin Inhibitor
- Rivaroxaban (Stroke Prevention — AF) · Direct Oral Anticoagulant — Factor Xa Inhibitor
- Acute Stroke / TIA Assessment · NICE NG128; RCP Stroke Guidelines 2023
- Status Epilepticus (Adults) · NICE CG137; ESEM guidelines; RCP Neurology Guidelines
- Suspected Subarachnoid Haemorrhage · NICE NG228; RCEM 2023; AHA/ASA 2023
- Adult Head Injury · NICE NG232 (2023)
- Bell's Palsy / Facial Nerve Palsy · ENT UK 2017; AAN
- Vertigo Workup · ENT UK; NICE CKS
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.