PLoS ONE (Jan 2014)

External validation of the MRI-DRAGON score: early prediction of stroke outcome after intravenous thrombolysis.

  • Guillaume Turc,
  • Pierre Aguettaz,
  • Nelly Ponchelle-Dequatre,
  • Hilde Hénon,
  • Olivier Naggara,
  • Xavier Leclerc,
  • Charlotte Cordonnier,
  • Didier Leys,
  • Jean-Louis Mas,
  • Catherine Oppenheim

DOI
https://doi.org/10.1371/journal.pone.0099164
Journal volume & issue
Vol. 9, no. 6
p. e99164

Abstract

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Background and purposeThe aim of our study was to validate in an independent cohort the MRI-DRAGON score, an adaptation of the (CT-) DRAGON score to predict 3-month outcome in acute ischemic stroke patients undergoing MRI before intravenous thrombolysis (IV-tPA).MethodsWe reviewed consecutive (2009-2013) anterior circulation stroke patients treated within 4.5 hours by IV-tPA in the Lille stroke unit (France), where MRI is the first-line pretherapeutic work-up. We assessed the discrimination and calibration of the MRI-DRAGON score to predict poor 3-month outcome, defined as modified Rankin Score >2, using c-statistic and the Hosmer-Lemeshow test, respectively.ResultsWe included 230 patients (mean ±SD age 70.4±16.0 years, median [IQR] baseline NIHSS 8 [5]-[14]; poor outcome in 78(34%) patients). The c-statistic was 0.81 (95%CI 0.75-0.87), and the Hosmer-Lemeshow test was not significant (p = 0.54).ConclusionsThe MRI-DRAGON score showed good prognostic performance in the external validation cohort. It could therefore be used to inform the patient's relatives about long-term prognosis and help to identify poor responders to IV-tPA alone, who may be candidates for additional therapeutic strategies, if they are otherwise eligible for such procedures based on the institutional criteria.