DRAGON Score for Post-TPA Stroke Outcome
The DRAGON score can help predict 90 day clinical outcomes in patients with ischemic stroke using only data that is available shortly after hospital arrival.
The DRAGON score was developed to make early predictions about clinical outcomes for ischemic stroke patients using only information that is available shortly after they arrive at the hospital and before tPA is given.
- Scored on a 0-10 point scale and used to predict clinical outcomes at 90 days (as defined by mRS), lower is better.
- 96-99% with a DRAGON score of 0 had a good outcome (mRS of 0-2) and none had a miserable outcome (mRS of 5-6).
- Conversely 97-100% of patients with a DRAGON score of 10 had miserable outcomes (mRS of 5-6).
Points to keep in mind:
- The DRAGON score has only been validated in retrospective studies of stroke databases.
- The authors of the DRAGON score suggest that patients with a miserable predicted outcome should be considered for endovascular therapy or hypothermia, though the benefits of those interventions are unproven and the recommendation is not evidence-based.
There are nearly 800,000 cases of acute stroke in the United States every year, with 130,000 associated deaths (4th leading cause of death in Americans).
The DRAGON score, especially at the low and high end of the scale, can help predict which patients are likely to have good clinical outcomes and those who are likely to have miserable clinical outcomes even if given tPA.