Functional outcome assessment for acute ischemic stroke who received recanalization therapy

Measure purpose: Ensure patients have a functional outcome assessment 90 days after acute ischemic stroke (AIS) event.

The numerator:  patients who have a Modified Rankin Score (mRS) administered by trained facility staff at the institution that completed the recanalization treatment documented between day 75 to 105 ( 90 days +/- 15 days) after intervention obtained
via telephone or in-person

is divided by

the denominator:  all patients discharged with AIS who received acute reperfusion therapy (i.e., IV t-PA, IA t-PA, or mechanical endovascular reperfusion).

Exclusions are removed from the denominator:

• Patient lost to follow-up (i.e., 3 phone call attempts at number documented during inpatient stay without response, registered mail sent without response, or home visit attempted without response.)
• Patients who had comfort measures documented within 48 hours of admission
• Patient declines
• mRS score at 90 days (+/-15 days) completed by alternate source and score documented in medical record

Key Phrases

Examples of key phrases you could use to meet the measure include:

• mRS (followed by numerical score) at 90 days
• 90 day mRS score is X (X = numerical score)

Measure Calculation Example

Dr. Okafor had 100 patients between January 1 and December 31 discharged with a diagnosis of AIS who received IV t-PA, IA t-PA, or mechanical endovascular reperfusion. This is the denominator.

Three patients declined to complete the mRS at 90 days, four were lost to further follow-up, and three had mRS scores at 90 days recorded by other physicians. These 10 (3+4+3) patients are removed from the denominator as they meet exclusions. 

Of the remaining 90 patients, Dr. Okafor documents a mRS at 90 days for 38 patients. 

Quality of patient care = 38/(100-10). Dr. Okafor has a score of 42.2% for this measure.