Suspected Large Vessel Occlusion (LVO) (v2021A)

Specifications Manual for Joint Commission National Quality Measures (v2021A)

Posted: 7/29/2020

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Release Notes:
Data Element
Version 2021A

Name:

Suspected Large Vessel Occlusion (LVO)

Collected For:

STK-OP-1

Definition:

Documentation in the medical record of a suspected large vessel cerebral artery occlusion.

Large vessel occlusions (LVO) include documentation of a cerebral occlusion in the Internal Carotid Artery (ICA), ICA terminus(T-lesion; T occlusion), Middle Cerebral Artery (MCA), M1 MCA, M2 MCA, Vertebral Artery, or Basilar Artery.

Question:

Is there documentation of a suspected LVO in the medical record?

Format:

Length:	1
Type:	Alphanumeric
Occurs:	1

Allowable Values:

Y (Yes) There is documentation of a suspected LVO.

N (No) There is no documentation of a suspected LVO, OR unable to determine from the medical record documentation.

Notes for Abstraction:

If there is ANY documentation of LVO prior to transfer to another hospital, select “Yes”. The percentage or degree of occlusion or stenosis is not needed to select “Yes” for this data element, e.g., “the patient has a LVO and requires transfer.”
- Documentation of LVO alone without the location of a specific cerebral artery is sufficient to select “Yes”.
- Disregard qualifiers describing the degree of occlusion, e.g., minimal/mild/moderate/high.
Documentation of suspected LVO, select “Yes”.
Acceptable examples (select “Yes”):
- Possible LVO requiring further evaluation.
- High probability of left side ELVO.
- Worrisome for ICA LVO.
- Suspicious for left MCA territory ischemic CVA.
If an occlusion is documented in any of the following cerebral arteries, select “Yes”: Internal Carotid Artery (ICA), ICA terminus (T-lesion; T occlusion), Middle Cerebral Artery (MCA), M1 MCA, M2 MCA, Vertebral Artery, or Basilar Artery.
- A brain imaging report is not needed to select “Yes”, but may be used for abstraction. Findings / impression documented by a radiologist may be used for abstraction as well as other documentation available in the medical record.
- The term LVO does not need to be linked with the cerebral artery.
If there is documentation in one source that indicates the patient has a LVO, AND there is documentation in another source that indicates the patient is NOT LVO (e.g., neurology report states positive for LVO, but radiology report states negative for LVO), the source that indicates the patient has LVO would be used for this data element. Contradictory or conflicting documentation, select “Yes”.
If after careful examination of circumstances, context, etc., documentation of LVO is still unclear, the case should be deemed "unable to determine” (select "No”).

Suggested Data Sources:

Consultation notes
Emergency department record
History and physical
Progress notes
Discharge summary
Diagnostic test reports

Additional Notes:

Guidelines for Abstraction:

Inclusion

Exclusion

Evolving large vessel occlusion (ELVO)
Hyperdensity or hyperdense sign in a defined location.
Opacification
Sylvian occlusion

None

Specifications Manual for Joint Commission National Quality Measures (v2021A)
Discharges 01-01-21 (1Q21) through 06-30-21 (2Q21)

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