ASTRAL Score Calculator
Predicts 90-day poor outcome in acute ischemic stroke
ASTRAL Score:
Clinical note: This calculator is for educational and clinical support use only.
It should not replace clinical judgment, stroke specialist assessment, emergency imaging,
thrombolysis or thrombectomy eligibility assessment, or local stroke protocols.
Scoring method:
- Age: 1 point for every 5 years, counted from 0; calculated as floor(age ÷ 5)
- Stroke severity: 1 point for every NIHSS point
- Onset-to-admission time > 3 hours: +2 points
- Any stroke-related visual field defect: +2 points
- Admission glucose > 7.3 mmol/L or < 3.7 mmol/L, approximately >131 mg/dL or <67 mg/dL: +1 point
- Decreased level of consciousness: +3 points
References:
- Ntaios G, Faouzi M, Ferrari J, Lang W, Vemmos K, Michel P. An integer-based score to predict functional outcome in acute ischemic stroke: the ASTRAL score. Neurology. 2012;78(24):1916-1922.
- Papavasileiou V, et al. ASTRAL score predicts 5-year dependence and mortality in acute ischemic stroke. Stroke. 2013.
- MDCalc. ASTRAL Score for Ischemic Stroke.
