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HDS-19.3 Data Details

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HDS-19.3 Increase the proportion of eligible patients with strokes who receive acute reperfusion therapy within 3 hours from symptom onset

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

Data Source: 
Get With the Guidelines-Stroke
Changed Since the Healthy People 2020 Launch: 
Yes
Measure: 
percent
Baseline (Year): 
74.1 (2009)
Target: 
81.5
Target-Setting Method: 
10 percent improvement
Numerator: 

Number of ischemic stroke (ICD-9-CM 433.x, 434.x and 436) patients who received acute reperfusion therapy [Intravenous recombinant tissue plasminogen activator (IV tPA)] within 3 hours from symptom onset

Denominator: 

Number of ischemic stroke patients eligible for acute reperfusion therapy [Intravenous recombinant tissue plasminogen activator (IV tPA)]

Comparable Healthy People 2010 Objective: 
Not applicable
Data Collection Frequency: 
Periodic
Methodology Notes: 

    Patients who are admitted within 2h of symptom onset are eligible to receive tPA, which must be delivered within 3h of symptom onset. If patients arrive later or with unknown time of onset, they are not included in the analysis because they are not considered eligible to meet the 3h window.

    Inclusion - Eligible stroke patients are those admitted for acute ischemic strokes. Exclusion - documented contraindications or warnings for not initiating IV thrombolytic in the 3hr treatment window or other hospital related factors such as delay in patient arrival, in-hospital time delay, delay in stroke diagnosis, or no IV access

    [delete old notes? Exclusion - 1) Transfer-in patients 2) Patients with a non-system reason for delay to fibrinolytic therapy 3) Patients with intracerebral hemorrhage strokes or subarachnoid hemorrhage strokes.]

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch: 
In 2015, this objective became measurable.

References

Additional resources about the objective

  1. Fonarow GC, Reeves MJ, Smith EE, Saver JL, Zhao X, Olson DW, Hernandez AF, Peterson ED, Schwamm LH. Characteristics, Performance Measures, and In-Hospital Outcomes of the First One Million Stroke and Transient Ischemic Attack Admissions in Get With The Guidelines-Stroke. Circ Cardiovasc Qual Outcomes 2010; 3(3):291-302. http://circoutcomes.ahajournals.org/content/3/3/291.full.pdf+html