Predicting Prognosis of Mechanical Thrombectomy in Acute Ischemic Stroke Patients Using Modified DRAGON Score
Journal of the Korean Neurological Association
The DRAGON score is reportedly useful for predicting the outcome of intravenous thrombolysis. This study tested whether the modified DRAGON (mDRAGON) score, in which the onset-to-treatment time is extended, can predict the long-term outcome of transient ischemic stroke (AIS) patients who are candidates for mechanical thrombectomy (MT). Methods: We assessed 40 AIS patients who were treated by MT alone or in combination with intravenous tissue plasminogen activator. The mDRAGON score is based on
... score is based on the following findings: hyperdense cerebral artery sign/early infarct signs on computed tomography (both=2, either=1, none=0), prestroke modified Rankin scale (mRS) score (>1=1), age (≥80 years=2, 65-79 years=1, <65 years=0), glucose level (>144 mg/dL=1), onset-to-treatment time (>230 minutes=1), and baseline National Institutes of Health Stroke Scale score (>15=3, 10-15=2, 5-9=1, 0-4=0). Receiver operating characteristics (ROC) curve analysis was used to compare the performance of the mDRAGON score with the performances of other stroke prediction scores. Results: Among 40 AIS patients treated with MT, the proportions with a good outcome (mRS score=0-2) in the groups with mDRAGON scores of 2 or 3, 4 or 5, 6 or 7, and 8-10 were 75%, 20%, 0%, and 0%, respectively, while the corresponding proportions with a poor outcome (mRS score=3-6) were 25%, 80%, 100%, and 100%. For the prediction of a good outcome at 3 months (mRS score=0-2), the area under the ROC curve of the mDRAGON scores was 0.87 (0.76-0.90). Conclusions: The mDRAGON score can be used to reliably predict the clinical outcome of AIS patients following endovascular treatment.