Performance Measurement Network

Question: Unable to Calculate LDL Value Due to High Triglycerides

What value should be used for mg/dl when the LDL is not able to be calculated due to high triglycerides? For AMI measures, the value of zero is entered. What is the correct procedure for Stroke measure 6 for the highest LDL value within 48 hours of hospital admission?

A direct LDL result was available (a send out laboratory test) but not until after the initial 48 hours of admission.

Answer:

If there is documentation that LDL-c testing was done within the first 48 hours or within 30 days prior to hospital arrival but no LDL-c values are available (e.g., unable to calculate value due to high triglyceride level), select “No” for the decision point LDL Measured. This decision is either "Yes" or "No". A value is not required.

LDL-c Greater Than or Equal to 100 mg/dL is also a "Yes" of "No" decision. LDL-c greater than or equal to 100 mg/dl is bypassed when the "No" pathway is selected for LDL Measured. Move on to the next decision point in the algorithm, which will be Statin Medication Prescribed at Discharge. (See Stroke Implementation Guide, Section 4, Pages 4-29 and 4-30). http://www.jointcommission.org/CertificationPrograms/PrimaryStrokeCenters/stroke_pm_edition_2_ver_2a.htm.

Question Details
Focus area(s): Chart Abstracted Measure Specifications – Clinical, Other
Related documents: STK-06, LDL ≥ 100 mg/dL,
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