In predicting outcomes for patients treated with thrombolysis after a stroke, the DRAGON score takes into account several clinical factors, each contributing to an overall assessment. Here's how it works:

The assessment considers six key elements:

1. Hyperdense cerebral artery or early signs of infarction on computed tomography:
   - None: 0 points
   - Either: 1 point
   - Both: 2 points

2. Modified Rankin Scale > 1 prior to the stroke:
   - Yes: 1 point
   - No: 0 points

3. Age bracket:
   - Less than 65: 0 points
   - 65 to 79: 1 point
   - 80 or older: 2 points

4. Baseline glucose levels exceeding 144 mg/dL:
   - Yes: 1 point
   - No: 0 points

5. Time from stroke onset to treatment exceeding 90 minutes:
   - Yes: 1 point
   - No: 0 points

6. Initial National Institutes of Health Stroke Scale score:
   - 0 to 4: 0 points
   - 5 to 9: 1 point
   - 10 to 15: 2 points
   - 16 or higher: 3 points

The sum of these individual scores generates a total DRAGON score ranging from 0 to 10. The score corresponds to potential recovery outcomes, interpreted as follows:

- A score of 0 or 1 indicates a very high likelihood (over 96%) of a good outcome (mRS 0-2) and 0% chance of a severely poor outcome (mRS 5-6).
- A score of 2 suggests a 96% probability of a good outcome and a 2% chance of a poor outcome.
- A score of 3 corresponds to an 87% probability of a good outcome and a 5% chance of a poor outcome.
- A score of 4 presents an 81% likelihood of a good outcome.
- Scores from 5 upwards shift towards a higher risk of unfavorable outcomes:
  - A score of 5 indicates an 83% likelihood of a poor outcome.
  - A score of 6: 90% likelihood of a poor outcome.
  - A score of 7: 97% likelihood of a poor outcome.
  - Scores from 8 to 10 imply near certainty (99%) of a poor outcome.

This tool assists clinicians in prognosis by combining patient characteristics into a quantifiable framework, guiding expectations and treatment approaches for post-stroke recovery.

The DRAGON score is a clinical calculator used to predict functional outcomes in stroke patients who have received tissue plasminogen activator (tPA) treatment. The acronym DRAGON stands for: Dense cerebral artery sign or Dense middle cerebral artery sign (D), age (R), Glucose level at baseline (G), Onset to treatment time (O), and National Institutes of Health Stroke Scale (NIHSS) score (N). 

This scoring system applies specifically to patients who have suffered an acute ischemic stroke and have been treated with intravenous tPA. The DRAGON score is used to predict the likelihood of a patient having a good outcome (defined as a modified Rankin Scale score of 0-2) at 3 months post-stroke, as well as the risk of symptomatic intracranial hemorrhage. 

There are no specific exclusion criteria for the use of the DRAGON score, but it should be noted that it is most applicable to patients who have received tPA treatment for acute ischemic stroke. It may not be as useful or accurate in predicting outcomes for patients with hemorrhagic stroke, those who did not receive tPA treatment, or those with other types of neurological conditions.

DRAGON score for post-TPA stroke outcome

DRAGON score predicts functional outcomes in acute ischemic stroke patients receiving both intravenous tissue plasminogen activator and endovascular therapy.