IV tPA not started reason

General Details:

Name:
IV tPA not started reason
Steward:
NINDS
Definition:
If NO Intravenous Tissue Plasminogen Activator (IV tPA) was initiated, documents reasons in the medical record for why no IV t-PA was started for the participant/subject at your hospital. Were one or more of the following reasons for not administering IV thrombolytic therapy at this hospital explicitly documented by a physician, advance practice nurse, or physician assistant's notes in the medical record?)
Registration Status:
Qualified

Permissible Values:

Value Type:
Value List
Unit of Measure:
Ids:
Value Code Name Code Code System Code Description
Active internal bleeding (<22 days) Active internal bleeding (<22 days) Active internal bleeding (<22 days)
CT findings (ICH, SAH, or major infarct signs) CT findings (ICH, SAH, or major infarct signs) CT findings (ICH, SAH, or major infarct signs)
History of intracranial hemorrhage or brain aneurysm or vascular malformation or brain tumor History of intracranial hemorrhage or brain aneurysm or vascular malformation or brain tumor History of intracranial hemorrhage or brain aneurysm or vascular malformation or brain tumor
Platelets <100,000, PTT> 40 sec after heparin use, or PT > 15 or INR > 1.7, or known bleeding diathesis Platelets <100,000, PTT> 40 sec after heparin use, or PT > 15 or INR > 1.7, or known bleeding diathesis Platelets <100,000, PTT> 40 sec after heparin use, or PT > 15 or INR > 1.7, or known bleeding diathesis
Recent intracranial or spinal surgery, head trauma, or stroke (<3 mo.) Recent intracranial or spinal surgery, head trauma, or stroke (<3 mo.) Recent intracranial or spinal surgery, head trauma, or stroke (<3 mo.)
Recent surgery/trauma (<15 days) Recent surgery/trauma (<15 days) Recent surgery/trauma (<15 days)
SBP > 185 or DBP > 110 mmHg despite treatment SBP > 185 or DBP > 110 mmHg despite treatment SBP > 185 or DBP > 110 mmHg despite treatment
Seizure at onset Seizure at onset Seizure at onset
Suspicion of subarachnoid hemorrhage Suspicion of subarachnoid hemorrhage Suspicion of subarachnoid hemorrhage
Subacute Bacterial Endocarditis (SBE) Subacute Bacterial Endocarditis (SBE) Subacute Bacterial Endocarditis (SBE)
Advanced age Advanced age Advanced age
Care-team unable to determine eligibility Care-team unable to determine eligibility Care-team unable to determine eligibility
Glucose < 50 or > 400 mg/dl Glucose < 50 or > 400 mg/dl Glucose < 50 or > 400 mg/dl
Increased risk of bleeding due to Acute pericarditis, SBE, Hemostatic defects, Diabetic hemorrhagic retinopathy, Septic thrombophlebitis/occluded AV cannula, or currently receiving oral anticoagulants Increased risk of bleeding due to Acute pericarditis, SBE, Hemostatic defects, Diabetic hemorrhagic retinopathy, Septic thrombophlebitis/occluded AV cannula, or currently receiving oral anticoagulants Increased risk of bleeding due to Acute pericarditis, SBE, Hemostatic defects, Diabetic hemorrhagic retinopathy, Septic thrombophlebitis/occluded AV cannula, or currently receiving oral anticoagulants
IV or IA tPA given at outside hospital IV or IA tPA given at outside hospital IV or IA tPA given at outside hospital
Left heart thrombus Left heart thrombus Left heart thrombus
Life expectancy < 1 year or severe co-morbid illness or CMO on admission Life expectancy < 1 year or severe co-morbid illness or CMO on admission Life expectancy < 1 year or severe co-morbid illness or CMO on admission
Pregnancy Pregnancy Pregnancy
Patient/Family refused Patient/Family refused Patient/Family refused
Rapid improvement Rapid improvement Rapid improvement
Stroke severity too mild Stroke severity too mild Stroke severity too mild
Stroke severity - Too severe (e.g., NIHSS >22) Stroke severity - Too severe (e.g., NIHSS >22) Stroke severity - Too severe (e.g., NIHSS >22)
Age > 80 Age > 80 Age > 80
Prior Stroke and Diabetes Prior Stroke and Diabetes Prior Stroke and Diabetes
Any anticoagulant use prior to admission (even if INR < 1.7) Any anticoagulant use prior to admission (even if INR < 1.7) Any anticoagulant use prior to admission (even if INR < 1.7)
NIHSS > 25 NIHSS > 25 NIHSS > 25
CT findings of >1/3 MCA CT findings of >1/3 MCA CT findings of >1/3 MCA
Delay in Patient Arrival Delay in Patient Arrival Delay in Patient Arrival
Delay in Stroke diagnosis Delay in Stroke diagnosis Delay in Stroke diagnosis
In-hospital Time Delay In-hospital Time Delay In-hospital Time Delay
No IV access No IV access No IV access
Other, specify Other, specify Other, specify

Designations:

Designation:
IV tPA not started reason
Tags:
Designation:
Reason(s) no IV tPA started at this hospital
Tags:
Question Text

Designations:

Definition:
If NO Intravenous Tissue Plasminogen Activator (IV tPA) was initiated, documents reasons in the medical record for why no IV t-PA was started for the participant/subject at your hospital. Were one or more of the following reasons for not administering IV thrombolytic therapy at this hospital explicitly documented by a physician, advance practice nurse, or physician assistant's notes in the medical record?)
Tags:

Reference Documents:

ID:
Title:
URI:
Provider Org:
Language Code:
Document:
Get With The Guidelines (GWTG) Stroke Patient Management Tool Coding Instructions (Updated on 11/4/2009); Paul Coverdell National Acute Stroke Registry

Identifiers:

Source:
NLM
Id:
PES1m_Y0YhB
Version:
3.1
Source:
NINDS
Id:
C14399
Version:
3
Source:
BRICS Variable Name
Id:
IVtPANotStartRsn
Version: