Question: The latest update indicates a favorable mRS as 0 1 or 2 post stroke with pre mRS 3 4 or 5

The latest update indicates a favorable mRS as: Ischemic stroke patients with an mRS less than or equal to two at 90 days (=75 days and =105 days) and an mRS three, four or five documented prior to the stroke. My question is: How are we supposed to get a post stroke mRS of 0-2 on someone who came in with a pre stroke mRS of 3,4 or 5?

Answer:

It's unlikely that you will get a mRS 0, 1, or 2 at 90 days for patients with a pre-stroke mRS < 2. The measure has been stratified to better identify these patients. It is likely that 0% or a very low percentage will be reported for the new 10b strata measure.

Since CSTK-10 is an outcome measure, we are interested in monitoring the number of ALL ischemic stroke patients who undergo a reperfusion procedure for the treatment of AIS and their mRS at 90 days. If a large/significant number of your total cases are mRS > 2 pre-stroke, this may be an opportunity for improvement. Rather than excluding these cases and reporting higher measure rates for CSTK-10 that may not be representative of overall performance, the measure has been stratified. Revisions to the measure will include Pre-Stroke mRS data in the numerator and become effective July 1, 2020.

Hope this clarifies for you. Thank you for your inquiry.