30 Day Stroke In-hospital Mortality
Unit of Analysis:
The unit of analysis is an "Episode of care". An episode of care refers to all contiguous in-patient acute care hospitalizations. For episodes with transfers within or between facilities, transactions were linked regardless of diagnoses. To construct an episode of care a transfer is assumed to have occurred if admission to an acute care institution occurs on the same day as or prior to discharge from another in-patient hospitalization.
Denominator (Index Episode)
- Stroke1 (ICD-10-CA: I60-I64; ICD-9CM: 430-432; 433-434 with fifth digit of 1; 436) is coded as MRDx but not also as a diagnosis type (2); or
- Where another diagnosis is coded as MRDx and also a diagnosis type (2), and a diagnosis of Stroke is coded as a type (1), or ; or
- Where rehabilitation (ICD-10: Z50.1, Z50.4-Z50.9; ICD-9CM: V57) is coded as MRDx and Stroke as a type (1), or .
- Admission between April 1 and March 1 of the following year (period of case selection ends March 1 to allow for 30 days of follow-up)
- Age at admission between 20 and 105 years
- Gender recorded as male or female
- Admission to an acute care institution
- Admission category recorded as urgent/emergent
- Canadian resident
- Records with an invalid Health Card Number
- Records with an invalid date of birth
- Records with an invalid admission date or time
- Records with an invalid discharge date or time
- Records with a stroke admission within one year prior to the admission date of the index episode
- Records where the stroke coded as most responsible is also coded as a post-admission diagnosis (diagnosis type (2))
The numerator is a subset of the denominator meeting the following condition:
All cause in-hospital death within 30 days of admission for stroke.
1 Cerebral infarctions due to thrombosis/embolism of precerebral arteries (ICD-10-CA: I63.0, I63.1, I63.2; ICD-9CM: 433 with fifth digit of 1) cannot be uniquely identified in ICD-9, therefore current definition is not recommended for ICD-9 coding system.