Quality statement 5 Minimising risk of – another stroke A patient with stroke, while in hospital, starts treatment and education to reduce their risk of another stroke. Indicator 5a: Discharge on criteria: Inclusions Patients diagnosed with antihypertensive medication haemorrhagic stroke (I61.x, (haemorrhagic stroke) I62.9).a Care type = ‘1’ (acute care).b Definitional attributes Exclusions Name: Proportion of patients with a final Nil. diagnosis of haemorrhagic stroke discharged on antihypertensive Total number of patients with a Denominator: medication, where not final diagnosis of haemorrhagic contraindicated.1 stroke who are discharged from hospital. Rationale: Hypertension is the strongest modifiable risk factor for recurrent Denominator stroke, and the efficacy of criteria: antihypertensive medication to Inclusions prevent stroke recurrence has Patients diagnosed with been demonstrated.1 haemorrhagic stroke (I61.x, I62.9).a Reduction in blood pressure, irrespective of initial blood Care type = ‘1’ (acute care).b pressure, has been shown to reduce the recurrence of stroke Exclusions and combined vascular events Patients for whom including myocardial infarction.2 antihypertensives are contraindicated and documented. Collection and usage attributes Setting: Acute/Hospital. Computation: (Numerator ÷ denominator) x 100 Comments: Contraindications for Numerator: Total number of patients with a antihypertensives may include final diagnosis of haemorrhagic symptomatic hypotension, patient stroke patients discharged from refusal, or where there are hospital on antihypertensive limitations of therapy (i.e. medication, where not advanced care directive is enacted contraindicated. and/or the patient is on a palliative care pathway). Numerator a ICD-10-AM (9th edition). b METeOR identifier: 491557.
Quality statement 5 – Minimising risk of another stroke A patient with stroke, while in hospital, starts treatment and education to reduce their risk of another stroke. Indicator 5a: Discharge on antihypertensive medication (haemorrhagic stroke) Definitional attributes Name: Proportion of patients with a final diagnosis of haemorrhagic stroke discharged on antihypertensive medication, where not contraindicated.1 Rationale: Hypertension is the strongest modifiable risk factor for recurrent stroke, and the efficacy of antihypertensive medication to prevent stroke recurrence has been demonstrated.1 Reduction in blood pressure, irrespective of initial blood pressure, has been shown to reduce the recurrence of stroke and combined vascular events including myocardial infarction.2 Collection and usage attributes Computation: (Numerator ÷ denominator) x 100 Numerator: Total number of patients with a final diagnosis of haemorrhagic stroke patients discharged from hospital on antihypertensive medication, where not contraindicated. Numerator criteria: Inclusions Patients diagnosed with haemorrhagic stroke (I61.x, I62.9).a Care type = ‘1’ (acute care).b Exclusions Nil. Denominator: Total number of patients with a final diagnosis of haemorrhagic stroke who are discharged from hospital. Denominator criteria: Inclusions Patients diagnosed with haemorrhagic stroke (I61.x, I62.9).a Care type = ‘1’ (acute care).b Exclusions Patients for whom antihypertensives are contraindicated and documented. Setting: Acute/Hospital. Comments: Contraindications for antihypertensives may include symptomatic hypotension, patient refusal, or where there are limitations of therapy (i.e. advanced care directive is enacted and/or the patient is on a palliative care pathway). a ICD-10-AM (9th edition). b METeOR identifier: 491557.