astral_stroke_score: ASTRAL Score for Ischemic Stroke

In cliot: Clinical Indices and Outcomes Tools

ASTRAL Score for Ischemic Stroke

Description

Calculates the ASTRAL (Acute Stroke Registry and Analysis of Lausanne) Score to predict the probability of an unfavorable functional outcome (modified Rankin Scale score > 2) at 3 months following an acute ischemic stroke.

Usage

astral_stroke_score(age, nihss, time_gt_3h, visual_field_defect, glucose,
                    loc_reduced, glucose_units = "mg/dL")

Arguments

age	Numeric. Patient age in years. (Score adds 1 point for every 5 years).
nihss	Numeric. Admission NIH Stroke Scale score (0-42). (Score adds 1 point for every 1 NIHSS point).
time_gt_3h	Numeric (0 or 1). Time from symptom onset to admission > 3 hours. (1 = Yes, +2 points).
visual_field_defect	Numeric (0 or 1). Presence of any visual field defect (from NIHSS item 3). (1 = Yes, +2 points).
glucose	Numeric. Admission blood glucose level. (> 131 mg/dL or > 7.3 mmol/L adds +1 point).
loc_reduced	Numeric (0 or 1). Reduced level of consciousness (NIHSS item 1a > 0). (1 = Yes, +2 points).
glucose_units	String. Units for glucose input. Options: "mg/dL" (default) or "mmol/L".

Value

A list containing:

ASTRAL_Score	The calculated integer score.
Unfavorable_Outcome_Probability_3mo	Estimated percentage probability of death or dependency (mRS 3-6) at 3 months.

References

Ntaios G, Faouzi M, Ferrari J, et al. An integer-based score to predict functional outcome in acute ischemic stroke: the ASTRAL score. Neurology. 2012;78(24):1916-1922. doi:10.1212/WNL.0b013e318259e221

Examples

# Example 1: High Risk
# 80yo (16pts), NIHSS 20, Time >3h (2), Visual Defect (2), Glucose 150 (1), Reduced LOC (2)
# Score = 16 + 20 + 2 + 2 + 1 + 2 = 43
astral_stroke_score(80, 20, 1, 1, 150, 1)

# Example 2: Moderate Risk
# 65yo (13pts), NIHSS 8, Time <3h (0), No Visual (0), Glucose 100 (0), Alert LOC (0)
# Score = 13 + 8 = 21
astral_stroke_score(65, 8, 0, 0, 100, 0)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.