DRAGON Score for Post-tPA Stroke Outcome
Predicts 3-month functional outcome after IV thrombolysis for ischaemic stroke, from pre-treatment data. Good outcome (mRS 0–2): 96% at 0–1 points, 0% at 8–10 (Strbian 2012). Not studied in basilar artery occlusion.
Score interpretation
DRAGON 0–3 — good outcome (mRS 0–2) at 3 months in 96% (0–1), 88% (2) and 74% (3) (Strbian 2012).
→ Proceed with tPA; good prognosis expected; standard post-thrombolysis monitoring
DRAGON 4–7 — intermediate prognosis; outcome less certain than at either end of the scale.
→ Clinical judgment on thrombolysis; family counselling on realistic outcomes; goal-directed care
DRAGON 8–10 — no patient had a good outcome; miserable outcome (mRS 5–6) in 70% at 8 and 100% at 9–10 (Strbian 2012).
→ Pre-procedure counselling with family about realistic outcomes; consider goals of care; tPA not contraindicated but outcomes likely poor; thrombectomy assessment important
Interpretation bands for the DRAGON Score. Apply clinical judgement and local guidance.
References
- Strbian D et al. Predicting outcome of IV thrombolysis-treated ischemic stroke patients: the DRAGON score. Neurology. 2012;78(6):427–432.
- Strbian D, et al. Validation of the DRAGON score in 12 stroke centers in anterior and posterior circulation. Stroke. 2013;44(10):2718–2721.
Related
Curated clinical cross-links plus same-class fallbacks.
- Tenecteplase (Stroke) · Stroke Thrombolysis
- Lisinopril (HFrEF / Post-MI) · ACE Inhibitor / HFrEF
- Colchicine (Pericarditis / Post-MI Inflammation) · Pericarditis / Coronary Inflammation
- Clopidogrel (ACS / Post-PCI) · Antiplatelet / ACS
- Alteplase (STEMI Thrombolysis) · Thrombolytic / STEMI
- Streptokinase (STEMI Thrombolysis) · Thrombolytic / STEMI
- Acute Stroke / TIA Assessment · NICE NG128; RCP Stroke Guidelines 2023
- Status Epilepticus (Adults) · NICE CG137; ESEM guidelines; RCP Neurology Guidelines
- Suspected Subarachnoid Haemorrhage · NICE NG228; RCEM 2023; AHA/ASA 2023
- Adult Head Injury · NICE NG232 (2023)
- Bell's Palsy / Facial Nerve Palsy · ENT UK 2017; AAN
- Vertigo Workup · ENT UK; NICE CKS
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.