Specifications Manual for Joint Commission National Quality Measures (v2019A)
Home » Proximal or Distal Occlusion

Release Notes:
Data Element
Version 2019A

Name:Proximal or Distal Occlusion
Collected For: CSTK-08
Definition:Documentation in the medical record of the location of the clot in either the large arteries in the neck or base of the brain (proximal), or small arteries higher up in the brain (distal). Arterial occlusions arising more proximally are associated with poorer outcomes.
Question:What is the location of the clot in the cerebral circulation?
Format:
Length:1
Type:Alphanumeric
Occurs:1
Allowable Values:

1  Proximal cerebral occlusion

2  Distal cerebral occlusion

3  Neither proximal or distal, OR unable to determine (UTD) from the medical record documentation
Notes for Abstraction:
  • If the occlusion is documented in an artery listed as an inclusion term for "proximal", select ‘1’.
  • If the occlusion is documented in an artery listed as an inclusion term for "distal", select ‘2’.
  • If multiple occlusions, select "proximal" or "distal" for the primary vessel occlusion.
  • If unable to determine, select ‘3’.
Suggested Data Sources:
  • Consultation notes
  • Emergency department record
  • History and physical
  • Progress notes
  • Discharge summary
  • Diagnostic test reports
  • Operative notes
  • Procedure notes
  • Admitting notes
  • Procedure reports
Additional Notes:
Guidelines for Abstraction:
Inclusion Exclusion
PROXIMAL:
  • Internal Carotid Artery (ICA)
  • ICA terminus
  • Middle Cerebral Artery (MCA)
  • Middle Cerebral Artery (MCA) M1 segment
  • M1
  • T-occlusion (T-lesion)
  • Vertebral Artery
  • Basilar Artery

DISTAL:
  • Anterior Cerebral Artery (ACA)
  • Anterior Cerebral Artery (ACA) A1 segment
  • A1
  • Anterior Cerebral Artery (ACA) A2 segment
  • A2
  • Anterior Cerebral Artery (ACA) A3 segment
  • A3
  • Middle Cerebral Artery (MCA) M2 segment
  • M2
  • Middle Cerebral Artery (MCA) M3 segment
  • M3
  • Middle Cerebral Artery (MCA) M4 segment
  • M4
  • Posterior Cerebral Artery (PCA)
  • Posterior Cerebral Artery (PCA) P1 segment
  • P1
  • Posterior Cerebral Artery (PCA) P2 segment
  • P2
  • Posterior Cerebral Artery (PCA) P3 segment
  • P3

None

Proximal or Distal Occlusion
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Specifications Manual for Joint Commission National Quality Measures (v2019A)
Discharges 07-01-19 (3Q19) through 12-31-19 (4Q19)

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