Antithrombotic Therapy By End of Hospital Day 2

• • Denominator

    • • TJC."Ischemic Stroke Encounter"

       

  • Denominator Exceptions

    • • "No Antithrombotic Ordered Day Of or Day After Hospital Arrival"
          union "Encounter With Pharmacological Contraindications for Antithrombotic Therapy Given Day Of or Day After Hospital Arrival"
          union "Encounter With An INR Greater Than 3.5"

       

  • Denominator Exclusions

    • • "Encounter Less Than Two Days"
          union "Encounter with Comfort Measures during Hospitalization"
          union "Encounter with Thrombolytic Therapy Given Prior To Arrival Or During Hospitalization"

       

  • Encounter Less Than Two Days

    • • TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
          where Global."HospitalizationWithObservationLengthofStay" ( IschemicStrokeEncounter ) < 2

       

  • Encounter With An INR Greater Than 3.5

    • • TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
          with ["Laboratory Test, Performed": "INR"] INR
            such that INR.resultDatetime during TJC."CalendarDayOfOrDayAfter" ( start of Global."HospitalizationWithObservation" ( IschemicStrokeEncounter ) )
              and INR.result > 3.5

       

  • Encounter with Antithrombotic Therapy

    • • TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
          with ["Medication, Administered": "Antithrombotic Therapy"] Antithrombotic
            such that Antithrombotic.relevantPeriod starts during TJC."CalendarDayOfOrDayAfter" ( start of Global."HospitalizationWithObservation" ( IschemicStrokeEncounter ) )

       

  • Encounter with Comfort Measures during Hospitalization

    • • TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
          with TJC."Intervention Comfort Measures" ComfortMeasures
            such that Coalesce(start of ComfortMeasures.relevantPeriod, ComfortMeasures.authorDatetime)during TJC."CalendarDayOfOrDayAfter" ( start of Global."HospitalizationWithObservation" ( IschemicStrokeEncounter ) )

       

  • Encounter With Pharmacological Contraindications for Antithrombotic Therapy Given Day Of or Day After Hospital Arrival

    • • TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
          with ["Medication, Administered": "Pharmacological Contraindications For Antithrombotic Therapy"] PharmacologicalContraindications
            such that PharmacologicalContraindications.relevantPeriod starts during TJC."CalendarDayOfOrDayAfter" ( start of Global."HospitalizationWithObservation" ( IschemicStrokeEncounter ) )

       

  • Encounter With Thrombolytic Therapy Documented As Already Given

    • • TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
          with [Diagnosis: "Intravenous or Intra arterial Thrombolytic (tPA) Therapy Prior to Arrival"] PriorTPA
            such that PriorTPA.authorDatetime during Global."HospitalizationWithObservation" ( IschemicStrokeEncounter )

       

  • Encounter with Thrombolytic Therapy Given Prior To Arrival Or During Hospitalization

    • • "Encounter with Thrombolytic Therapy Medication or Procedures"
          union "Encounter With Thrombolytic Therapy Prior to Arrival"
          union "Encounter With Thrombolytic Therapy Documented As Already Given"

       

  • Encounter with Thrombolytic Therapy Medication or Procedures

    • • TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
          with "Thrombolytic Therapy Medication or Procedures" ThrombolyticTherapy
            such that ThrombolyticTherapy.relevantPeriod starts during Interval[start of Global."HospitalizationWithObservation" ( IschemicStrokeEncounter ) - 24 hours, 
            end of Global."HospitalizationWithObservation" ( IschemicStrokeEncounter ) )

       

  • Encounter With Thrombolytic Therapy Prior to Arrival

    • • TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
          where exists IschemicStrokeEncounter.diagnoses Diagnosis
            where Diagnosis.code in "Intravenous or Intra arterial Thrombolytic (tPA) Therapy Prior to Arrival"

       

  • Initial Population

    • • TJC."Encounter with Principal Diagnosis and Age"

       

  • No Antithrombotic Administered

    • • ["Medication, Not Administered": "Antithrombotic Therapy"] NoAntithromboticGiven
          where NoAntithromboticGiven.negationRationale in "Medical Reason"
            or NoAntithromboticGiven.negationRationale in "Patient Refusal"

       

  • No Antithrombotic Ordered

    • • "No Antithrombotic Ordered for Medical Reason or Patient Refusal"
          union "No Antithrombotic Administered"

       

  • No Antithrombotic Ordered Day Of or Day After Hospital Arrival

    • • TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
          with "No Antithrombotic Ordered" NoAntithrombotic
            such that NoAntithrombotic.authorDatetime during TJC."CalendarDayOfOrDayAfter" ( start of Global."HospitalizationWithObservation" ( IschemicStrokeEncounter ) )

       

  • No Antithrombotic Ordered for Medical Reason or Patient Refusal

    • • ["Medication, Not Ordered": "Antithrombotic Therapy"] NoAntithromboticOrder
          where NoAntithromboticOrder.negationRationale in "Medical Reason"
            or NoAntithromboticOrder.negationRationale in "Patient Refusal"

       

  • Numerator

    • • "Encounter with Antithrombotic Therapy"

       

  • SDE Ethnicity

    • • ["Patient Characteristic Ethnicity": "Ethnicity"]

       

  • SDE Payer

    • • ["Patient Characteristic Payer": "Payer"]

       

  • SDE Race

    • • ["Patient Characteristic Race": "Race"]

       

  • SDE Sex

    • • ["Patient Characteristic Sex": "ONC Administrative Sex"]

       

  • Thrombolytic Therapy Medication or Procedures

    • • ["Medication, Administered": "Thrombolytic (t-PA) Therapy"]
          union ["Procedure, Performed": "Intravenous or Intra-arterial Thrombolytic (t-PA) Therapy"]

       

  • TJC.All Stroke Encounter

    • • "Non Elective Inpatient Encounter" NonElectiveEncounter
          where exists ( NonElectiveEncounter.diagnoses Diagnosis
              where Diagnosis.rank = 1
                and ( Diagnosis.code in "Hemorrhagic Stroke"
                    or Diagnosis.code in "Ischemic Stroke"
                )
          )

       

  • TJC.Encounter with Principal Diagnosis and Age

    • • "All Stroke Encounter" AllStrokeEncounter
          with ["Patient Characteristic Birthdate": "Birth date"] BirthDate
            such that Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of AllStrokeEncounter.relevantPeriod ) >= 18

       

  • TJC.Intervention Comfort Measures

    • • ["Intervention, Order": "Comfort Measures"]
          union ["Intervention, Performed": "Comfort Measures"]

       

  • TJC.Ischemic Stroke Encounter

    • • "Encounter with Principal Diagnosis and Age" EncounterWithAge
          where exists ( EncounterWithAge.diagnoses Diagnosis
              where Diagnosis.code in "Ischemic Stroke"
                and Diagnosis.rank = 1
          )

       

  • TJC.Non Elective Inpatient Encounter

    • • ["Encounter, Performed": "Non-Elective Inpatient Encounter"] NonElectiveEncounter
          where Global."LengthInDays" ( NonElectiveEncounter.relevantPeriod ) <= 120
            and NonElectiveEncounter.relevantPeriod ends during "Measurement Period"

       

Functions

eMeasure Stroke (eSTK)