ASTRAL Score (90-Day Stroke Outcome)

ASTRAL score: 1 point per 5 years of age, 1 per NIHSS point, onset > 3 h, new visual-field defect, abnormal admission glucose, and impaired consciousness predict the 90-day unfavorable-outcome probability after ischemic stroke.

Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.

Example

Age
75 years
Admission NIHSS
10
Onset > 3 h (or unknown)
Yes
New visual-field defect
No
Admission glucose > 7.3 or < 3.7 mmol/L
No
Impaired consciousness
No

Result: ASTRAL score 27 — higher scores predict a higher 90-day unfavorable-outcome probability.

The tool opens with these values already filled in. Replace them with your own.

What the result means

Score
A rising integer score maps to a higher probability of 90-day unfavorable outcome (mRS > 2). A prognostic score, not a treatment order.

What you enter

  • Age
  • Admission NIHSS
  • Onset > 3 h (or unknown) (+2)
  • New visual-field defect (+2)
  • Admission glucose > 7.3 or < 3.7 mmol/L (+1)
  • Impaired consciousness (+3)
How this is calculated

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. Read the source ↗

A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.

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Built by Clay Good. Source on GitHub.