Performance Measurement Network

Question: can we accept a Drs documentation that it is not a hemorragic transformation

even if the nihss is increased by 4 and there is positive imaging.


The measure doesn't work that way. A hemorrhagic transformation by definition is: Ischemic stroke patients who develop a symptomatic intracranial hemorrhage (= "Yes" for Positive Brain Image AND greater than or equal to 4 point increase in NIHSS within the first 36 hours after IV/IA t-PA or MER (= Highest NIHSS Score Documented Within 36 Hours Following IV t-PA or IA t-PA or MER minus NIHSS Score Documented Closest to IV t-PA or IA t-PA or MER Initiation). Both conditions must be met to include the case in the numerator. A Positive Brain Bleed alone or a Clinical Deterioration greater than/= to 4 pt NIHSS alone does not put the case in the numerator. Hope this clarifies for you. Thank you for your inquiry.))

Question Details
Focus area(s): Chart Abstracted Measure Specifications – Clinical
Related documents: CSTK, CSTK-05, NIHSS Score Documented Closest to IV Thrombolytic Initiation
Manual: Current Manual (current data collection period; prior to data transmission)

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