title: External validation of the MRI-DRAGON score: early prediction of stroke outcome after intravenous thrombolysis.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Neurology, Hôpital Sainte-Anne, Paris, France & Université Paris Descartes, Sorbonne Paris Cité, INSERM UMR S894.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Turc
authors.affiliation: Department of Radiology, Lille University Hospital, Lille, France & Université Lille Nord de France, UDSL, EA 1046.
authors.forename: Pierre
authors.initials: P
authors.lastname: Aguettaz
authors.affiliation: Department of Neurology, Lille University Hospital, Lille, France & Université Lille Nord de France, UDSL, EA 1046.
authors.forename: Nelly
authors.initials: N
authors.lastname: Ponchelle-Dequatre
authors.affiliation: Department of Neurology, Lille University Hospital, Lille, France & Université Lille Nord de France, UDSL, EA 1046.
authors.forename: Hilde
authors.initials: H
authors.lastname: Hénon
authors.affiliation: Department of Radiology, Hôpital Sainte-Anne, Paris, France & Université Paris Descartes, Sorbonne Paris Cité, INSERM UMR S894.
authors.forename: Olivier
authors.initials: O
authors.lastname: Naggara
authors.affiliation: Department of Radiology, Lille University Hospital, Lille, France & Université Lille Nord de France, UDSL, EA 1046.
authors.forename: Xavier
authors.initials: X
authors.lastname: Leclerc
authors.affiliation: Department of Neurology, Lille University Hospital, Lille, France & Université Lille Nord de France, UDSL, EA 1046.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Cordonnier
authors.affiliation: Department of Neurology, Lille University Hospital, Lille, France & Université Lille Nord de France, UDSL, EA 1046.
authors.forename: Didier
authors.initials: D
authors.lastname: Leys
authors.affiliation: Department of Neurology, Hôpital Sainte-Anne, Paris, France & Université Paris Descartes, Sorbonne Paris Cité, INSERM UMR S894.
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Mas
authors.affiliation: Department of Radiology, Hôpital Sainte-Anne, Paris, France & Université Paris Descartes, Sorbonne Paris Cité, INSERM UMR S894.
authors.forename: Catherine
authors.initials: C
authors.lastname: Oppenheim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D007275:Injections, Intravenous; D008279:Magnetic Resonance Imaging; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis* / Q000188:drug therapy*; D015912:Thrombolytic Therapy
chemical_list: D005343:Fibrinolytic Agents