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Acute coronary syndromes clinical care standard indicators: 3c-Proportion of patients with ST-segment-elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI) within 90 minutes of first clinical contact, 2019-

Identifying and definitional attributes

Metadata item type:Help on this termIndicator
Indicator type:Help on this termIndicator
Short name:Help on this termIndicator 3c-Proportion of patients with STEMI treated with PCI within 90 minutes of first clinical contact
METeOR identifier:Help on this term719392
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) treated with percutaneous coronary intervention (PCI), within 90 minutes of first clinical contact.

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

"First clinical contact" is defined as a paramedic or nurse who can administer fibrinolysis.

Both the numerator and the denominator include patients with STEMI.

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.

The denominator excludes patients for whom PCI is contraindicated (where the contraindication is documented in their medical record). Contraindications for PCI and fibrinolysis may include advance care directives, being on a palliative care pathway, and clinical judgement, subject to discussion with patients, family and carers.

For patients first seen by a paramedic who can administer fibrinolysis, time of first clinical contact is the time the paramedic first saw the patients. For those patients who are NOT seen been a paramedic who can administer fibrinolysis, time of first clinical contact is the time of presentation at hospital. Or in the case where the patient is transfered from a non-PCI capable hospital, the time of presentation at the first hospital.

Presented as a percentage.

Computation:Help on this term

(Numerator ÷ denominator) x 100

Numerator:Help on this term

Number of patients with STEMI, treated with PCI, within 90 minutes of first clinical contact.

Denominator:Help on this term

Number of patients with STEMI who arrive at a PCI-capable hospital or are transferred from a non PCI‑capable hospital.

Comments:Help on this term

It is recognised that this target of 90 minutes is difficult to achieve in the management of patients with STEMI who suffer a cardiac arrest, and for whom advanced resuscitation is effected prior to PCI.

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

Reference documents:Help on this term

National Heart Foundation of Australia & Cardiac Society of Australia and New Zealand 2016 Executive Working Group 2016. Australian clinical guidelines for the management of acute coronary syndromes 2016. Heart, Lung, and Circulation 25: 895-951.

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