Quality statement 2 Time-critical therapy – Indicator 2e: Time from onset of thrombolytic agent or intervention. symptoms to thrombolysis IQR is calculated by subtracting the value at the 1st quartile (lower) Definitional attributes from the 3rd quartile (upper): Name: Time from onset of symptoms to IQR = xu xl – thrombolysis for patients with a Both median and IQR are final diagnosis of ischaemic stroke. calculated using the total number Rationale: Meta-analysis of clinical trials has of patients with a final diagnosis of shown that thrombolysis improves ischaemic stroke (I63.x, 164)a,b outcomes and the outcomes are who are thrombolysed. more pronounced with earlier intervention.1 Recombinant tissue Setting : Acute/Hospital. plasminogen activator (rtPA) given up to 4.5 hours (i.e. up to 270 Comments: A denominator is not required for minutes) after ischaemic stroke this indicator since median is onset is associated with an calculated by locating the increased chance of favourable 50th percentile. outcomes.1 The interquartile range (IQR) is the Collection and usage attributes difference between the third and the first quartiles. It is a measure Computation: Time (in minutes) from symptom of dispersion. onset to administration of thrombolytic agent or intervention. References Data for this indicator is analysed 1. Wardlaw JM, Murray V, Berge E, del Zoppo GJ. as median time and interquartile Thrombolysis for acute ischaemic stroke. The Cochrane range (IQR) (in minutes) from database of systematic reviews 2014;7. symptom onset to administration of a ICD-10-AM (9th edition). b Note that although 164 is not specified as haemorrhage or more than 80% of strokes coded to this category ‘Stroke, infarction’, are ischaemic.
Quality statement 2 – Time-critical therapy Indicator 2e: Time from onset of symptoms to thrombolysis Definitional attributes Name: Time from onset of symptoms to thrombolysis for patients with a final diagnosis of ischaemic stroke. Rationale: Meta-analysis of clinical trials has shown that thrombolysis improves outcomes and the outcomes are more pronounced with earlier intervention.1 Recombinant tissue plasminogen activator (rtPA) given up to 4.5 hours (i.e. up to 270 minutes) after ischaemic stroke onset is associated with an increased chance of favourable outcomes.1 Collection and usage attributes Computation: Time (in minutes) from symptom onset to administration of thrombolytic agent or intervention. Data for this indicator is analysed as median time and interquartile range (IQR) (in minutes) from symptom onset to administration of thrombolytic agent or intervention. IQR is calculated by subtracting the value at the 1st quartile (lower) from the 3rd quartile (upper): IQR = xu – xl Both median and IQR are calculated using the total number of patients with a final diagnosis of ischaemic stroke (I63.x, 164)a,b who are thrombolysed. Setting : Acute/Hospital. Comments: A denominator is not required for this indicator since median is calculated by locating the 50th percentile. The interquartile range (IQR) is the difference between the third and the first quartiles. It is a measure of dispersion. References 1. Wardlaw JM, Murray V, Berge E, del Zoppo GJ. Thrombolysis for acute ischaemic stroke. The Cochrane database of systematic reviews 2014;7. a ICD-10-AM (9th edition). b Note that although 164 is ‘Stroke, not specified as haemorrhage or infarction’, more than 80% of strokes coded to this category are ischaemic.
Acute-Stroke-IndicatorSpecification.docx