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Question: Included populations in CSTK-01

While reviewing the CSTK-01, NIHSS performed for Ischemic stroke patients, it is ambiguous to me which patients are included in this Core Measure. I find conflicting information for who is included in the numerator and denominator. We are a Primary Certified Stroke Program through TJC and do not perform EVT, and this is one of our new Core Measures. Are all ischemic stroke patients included in this Core Measure, or is it only those that receive tPA or EVT. Our stroke coordinator says it should only be those with tPA or EVT, and I'm interpreting it as all ischemic stroke patients. Which populations are included in this measure.

Answer:

Nancy, The CSTK-01 denominator population includes ALL ischemic stroke patients - both those who undergo Iv/IA t-PA or MER and those who do not undergo reperfusion.

The CSTK-01 numerator population uses different criteria for those ischemic stroke patients who undergo IV/IA t-PA (i.e., NIHSS must be prior to the procedure) AND those who do not (i.e., NIHSS done and documented within 12 hours of hospital arrival.)

If your a PSC that does not do MT or give IA t-PA, then reperfusion is limited to those patients with IV t-PA only and NIHSS should be done and documented prior to IV thrombolytic initiation.

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

Question Details
Focus area(s): Measure Algorithms – Technical (chart abstracted)
Related documents: CSTK-01,
Manual: Current Manual (current data collection period; prior to data transmission)
File: CSTK-01 Numerator and Denominator.docx

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