The stroke (STK) measure, STK-4, represents a subset of patients with Acute Ischemic Stroke (AIS) 13

All-AIS treatment rate provides a broader perspective than STK-4

Centers for Medicare and Medicaid Services (CMS) requires reporting on designated quality measures, such as STK-4, in order to receive a higher annual update to Medicare MS-DRG rates. Metrics like STK-4 treatment rates evaluate patients for whom thrombolytic therapy was initiated within 3 hours of time last known well. However, STK-4 excludes patients not arriving within 2 hours of time last known well or with any other documented reason for not initiating an IV thrombolytic. This may not account for potential candidates for whom treatment may be appropriate.

In contrast, an All-AIS treatment rate can provide a broader perspective. An All-AIS treatment rate is a more comprehensive metric that measures the percentage of patients with a discharge diagnosis of AIS that were treated with Activase® (alteplase).

All-AIS treatment rate can capture both eligible and ineligible patients. For eligible patients, it is important to consider the entire safety profile when making treatment decisions. According to the labeled indication, treatment must be initiated within 3 hours of symptom onset, after the exclusion of ICH as the primary cause of stroke signs and symptoms.

STK-4 treatment

Hypothetical example. Not based on actual patient data.

Considering the all-AIS treatment rate, would it be valuable to have a deeper understanding of the reasons why patients diagnosed with AIS were not considered for Activase?
  • How many were outside the Activase time window?
  • How many were excluded due to contraindications?
  • How many were perceived ineligible?
What is the STK-4 treatment rate at your institution? What is the overall AIS treatment rate?
Considering this larger pool of patients, what conclusions can be drawn about your institution’s stroke program?
Do you track every discharged patient with a confirmed AIS diagnosis, all-AIS treatment rates, regardless of treatment options?

Identify process gaps to improve your stroke program >