Easy-to-perform and valid assessment scales for the effect of thrombolysis are essential in hyperacute stroke settings. Because of this we performed an external validation of the DRAGON scale proposed by Strbian et al. in a Danish cohort. All patients treated with intravenous recombinant plasminogen activator between 2009 and 2011 were included. Upon admission all patients underwent physical and neurological examination using the National Institutes of Health Stroke Scale along with non-contrast CT scans and CT angiography. Patients were followed up through the Outpatient Clinic and their modified Rankin Scale (mRS) was assessed after 3 months. Three hundred and three patients were included in the analysis. The DRAGON scale proved to have a good discriminative ability for predicting highly unfavourable outcome (mRS 5–6) (area under the curve-receiver operating characteristic [AUC-ROC]: 0.89; 95% confidence interval [CI] 0.81–0.96; p < 0.001) and good outcome (mRS 0–2) (AUC-ROC: 0.79; 95% CI 0.73–0.85; p < 0.001). When only patients with M1 occlusions were selected the DRAGON scale provided good discriminative capability (AUC-ROC: 0.89; 95% CI 0.78–1.0; p = 0.003) for highly unfavourable outcome. We confirmed the validity of the DRAGON scale in predicting outcome after thrombolysis treatment.
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- Predicting outcome of IV thrombolysis-treated ischemic stroke patients: the DRAGON score.Neurology. 2012; 78: 427-432
- National institutes of health stroke scale score is poorly predictive of proximal occlusion in acute cerebral ischemia.Stroke. 2009; 40: 2988-2993
Accepted: April 13, 2013
Received: January 14, 2013
© 2013 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.