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The JAGUAR Score Predicts 1-Month Disability/Death in Ischemic Stroke Patient Ineligible for Recanalization Therapy

Aryandhito Widhi Nugroho1, Hisatomi Arima2, Naoyuki Takashima3

  • 1Department of Neurosurgery, Shiga University of Medical Science, Otsu, Japan; Department of Neurosurgery, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia; Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|June 27, 2018
PubMed

Insights

A new scoring system, JAGUAR, predicts severe disability or death in acute ischemic stroke patients ineligible for recanalization therapy. This tool is simple, applicable on admission, and suitable for Asian developing countries.

Area of Science:

  • Neurology
  • Public Health
  • Medical Informatics

Background:

  • Existing stroke outcome prediction tools are often developed in Western populations.
  • Acute ischemic stroke (AIS) patient outcomes vary significantly based on geographic and socioeconomic factors.
  • There is a need for accessible prediction scores in resource-limited settings.

Purpose of the Study:

  • To develop and validate a simple, on-admission prediction score for 1-month severe disability or death in AIS patients.
  • To focus on patients ineligible for recanalization therapy.
  • To ensure the score utilizes readily available clinical, laboratory, and radiological data relevant to Asian developing countries.

Main Methods:

  • Utilized the Shiga Stroke Registry, a large Japanese population-based dataset.
  • Conducted multivariable logistic regression on 1617 AIS patients ineligible for recanalization.
  • Developed the JAGUAR score based on significant predictors and validated its discrimination and calibration.

Main Results:

  • Identified Japan Coma Scale, age, random glucose, onset-to-arrival time, atrial fibrillation, and preadmission dependency as key predictors.
  • The JAGUAR score demonstrated excellent discrimination with an Area Under the Curve of 0.901.
  • The score showed good calibration in the study population.

Conclusions:

  • The JAGUAR score is a valuable tool for predicting severe outcomes in AIS patients ineligible for reperfusion therapy.
  • Its simplicity and reliance on basic data make it highly applicable upon admission in Asian developing countries.
  • No complex calculations or advanced neuroimaging are required for its use.
Abstract

Keywords:
Ischemic strokeoutcomeprognosissevere disability/death

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