DRAGON Score Helps Predict Functional Outcomes in Stroke

Functional outcome prediction score, based on pretreatment parameters, validated externally

MONDAY, Feb. 6 (HealthDay News) -- A new scoring method can aid clinicians in predicting functional outcomes for patients with ischemic stroke receiving intravenous (IV) alteplase, according to a study published in the Feb. 7 issue of Neurology.

Daniel Strbian, M.D., Ph.D., of Helsinki University Central Hospital, and colleagues developed a functional outcome prediction score by studying the immediate pretreatment parameters and three-month outcomes in 1,319 ischemic stroke patients treated with IV alteplase. The accuracy of the model was evaluated with bootstrapping. External validation was performed in a cohort of 330 patients treated at the University Hospital Basel in Switzerland.

The researchers developed the 10-point DRAGON scale based on (hyper)Dense cerebral artery sign or early infarct signs on admission computed tomography scan; prestroke modified Rankin Scale (mRS) score; Age; Glucose level at baseline; Onset-to-treatment time; and baseline National Institutes of Health Stroke Scale score. The area under the receiver operator characteristic curve was 0.84 in the original cohort and 0.80 in the validation cohort. For patients with a score of 0-1, 2, 3, and 8-10 points, the proportions of patients with good outcomes (mRS score, 0 to 2) were 96, 88, 74, and 0 percent, respectively. For patients with a score of 0-1, 2, 3, 8, and 9-10 points, the proportions with miserable outcomes (mRS score, 5 to 6) were 0, 2, 5, 70, and 100 percent, respectively. Similar results were seen with external validation.

"The DRAGON score is valid at our site and was reliable externally," the authors write.

Several authors disclosed financial ties to pharmaceutical companies. One author disclosed involvement with patents related to the study subject matter.

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