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External Validation of the MRI-DRAGON Score: Early Prediction of Stroke Outcome after Intravenous Thrombolysis

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

Abstract

Background and Purpose: The 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). Methods: We 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. Results: We 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). Conclusions: The 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.

Suggested Citation

  • Guillaume Turc & Pierre Aguettaz & Nelly Ponchelle-Dequatre & Hilde Hénon & Olivier Naggara & Xavier Leclerc & Charlotte Cordonnier & Didier Leys & Jean-Louis Mas & Catherine Oppenheim, 2014. "External Validation of the MRI-DRAGON Score: Early Prediction of Stroke Outcome after Intravenous Thrombolysis," PLOS ONE, Public Library of Science, vol. 9(6), pages 1-5, June.
    • Handle: RePEc:plo:pone00:0099164
    DOI: 10.1371/journal.pone.0099164
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