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Acute coronary syndromes clinical care standard indicators: 3a-Proportion of patients with ST-segment-elevation myocardial infarction (STEMI) receiving fibrinolysis or percutaneous coronary intervention (PCI), 2019-

Identifying and definitional attributes

Metadata item type:Help on this termIndicator
Indicator type:Help on this termIndicator
Short name:Help on this termIndicator 3a-Proportion of STEMI patients receiving fibrinolysis or PCI
METeOR identifier:Help on this term719388
Registration status:Help on this termAustralian Commission on Safety and Quality in Health Care, Standardisation pending 17/09/2019
Description:Help on this term

Proportion of patients with ST-segment-elevation myocardial infarction (STEMI) presenting within 12 hours of symptom onset receiving fibrinolysis or percutaneous coronary intervention (PCI).

Indicator set:Help on this termClinical care standard indicators: acute coronary syndromes Australian Commission on Safety and Quality in Health Care, Standardisation pending 17/09/2019

Collection and usage attributes

Computation description:Help on this term

Both the numerator and the denominator include patients with STEMI.

Both the numerator and denominator exclude patients with a diagnosis of left bundle branch block (LBBB). This is where Episode of care—principal diagnosis, code (ICD-10-AM 11th edn) ANN{.N[N]} or Episode of care—additional diagnosis, code (ICD-10-AM 11th edn) ANN{.N[N]} is one of the following:

  • I44.4 Left anterior fascicular block
  • I44.5 Left posterior fascicular block
  • I44.6 Other and unspecified fascicular block
  • I44.7 Left bundle-branch block, unspecified.

For the numerator, patients undergoing PCI include those for which one of the following Episode of admitted patient care—procedure, code (ACHI 11th edn) NNNNN-NN is recorded:

  • 38300-00 [670] Percutaneous transluminal balloon angioplasty of 1 coronary artery
  • 38303-00 [670] Percutaneous transluminal balloon angioplasty of >=2 coronary arteries
  • 38306-00 [671] Percutaneous insertion of 1 transluminal stent into single coronary artery
  • 38306-01 [671] Percutaneous insertion of >= 2 transluminal stents into single coronary artery
  • 38306-02 [671] Percutaneous insertion of >= 2 transluminal stents into multiple coronary arteries.

Alternatively, for hospitals collecting the Acute coronary syndrome (clinical) National best practice data set, the data element Person—percutaneous coronary intervention procedure type, code N can be used, where there is a value of 1 Balloon angioplasty only, 2 Bare metal stent implantation or 3 Drug-eluting stent implantation recorded.

The numerator also includes patients who are administered fibrinolytic drugs. These are not coded using the Australian Classification of Health Interventions (ACHI). However, for hospitals using the Acute coronary syndrome (clinical) National best practice data set, the data element Person—fibrinolytic drug administered, code N can be used to indicate fibrinolytic drug therapy, where the values are one of the following:

1 Streptokinase
2 t-PA (Tissue Plasminogen Activator) (Alteplase)
3 r-PA (Reteplase)
4 TNK t-PA (Tenecteplase)

The denominator excludes patients for whom PCI and fibrinolysis are contraindicated (where the contraindication is documented in their medical record). (For hospitals using the Acute coronary syndrome (clinical) National best practice data set, contraindication for fibrinolytic therapy can be identified using the data element Person—reason for non prescription of pharmacotherapy, code N, where a value of 2 'Contraindicated' is recorded.) Contraindications may include advance care directives, being on a palliative care pathway, and clinical judgement, subject to discussion with patients, family and carers.

Presented as a percentage.

Computation:Help on this term

(Numerator ÷ denominator) x 100

Numerator:Help on this term

Number of patients with STEMI arriving at the emergency department or being attended to by ambulance officers within 12 hours of symptom onset, who receive fibrinolysis or PCI.

Denominator:Help on this term

Number of patients with STEMI arriving at the emergency department or being attended to by ambulance officers within 12 hours of symptom onset.

Representational attributes

Representation class:Help on this termPercentage
Data type:Help on this termReal
Unit of measure:Help on this termEpisode
Format:Help on this term

N[NN]

Source and reference attributes

Submitting organisation:Help on this term

Australian Commission on Safety and Quality in Health Care

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