Dataset Changes Helpnotes 2017 Question No Question Answer Options Guidance/Definition 2.1.7 Was the patient on anticoagulant medication prior to admission? Yes No No but Yes is available even if patient is not in AF prior to this admission. To select ‘No but’ in answer to this question that it is recorded that a prescriber judged the patient’s risk of a bleeding complication to outweigh the benefit in stroke risk reduction. If this cannot be confirmed then the answer to this question is ‘No’. Anticoagulation refers to treatment with an anticoagulant: Vitamin K antagonists: Warfarin and Phenindione DOAC = Direct Oral Anticoagulant: Apixaban (Eliquis), Rivaroxaban (Xarelto) and Dabigatran (Pradaxa), Edoxaban (Lixiana). Heparin = Includes treatment dose unfractionated heparin and Low Molecular Weight Heparin Anticoagulation does not refer to treatment with aspirin, clopidogrel or another antiplatelet agent. 2.1.7(a) What anticoagulation was the patient prescribed before their stroke? Vitamin K antagonist (includes Warfarin) DOAC Heparin Available if 2.1.7 = ‘Yes’. Select all that apply. Vitamin K antagonists: Warfarin and Phenindione DOAC = Direct Oral Anticoagulant: Apixaban (Eliquis), Rivaroxaban (Xarelto) and Dabigatran (Pradaxa), Edoxaban (Lixiana). Heparin = Includes treatment dose unfractionated heparin and Low Molecular Weight Heparin 2.1.7(b) What was the patient’s International Normalised ratio (INR) on arrival at hospital (if inpatient, INR at the time of stroke onset)? Value range: 0.0 – 10.00 INR not checked Greater than 10 Available if 2.1.7(a) = ‘Vitamin K antagonist’ If inpatient, INR at the time of stroke should be used.
2.15 Was the patient given anticoagulant reversal therapy? Yes No Available if 2.1.7 = ‘Yes’ and 2.5 = PIH. Refers to specific treatment to reverse the effects of anticoagulant treatment, including PCC (Prothrombin Complex Concentrate), DOAC antidote, FFP (Fresh Frozen Plasma), Protamine and/or Vitamin K. 2.15.1 If yes, 2.15.1. What reversal agent was given? PCC DOAC antidote FFP Protamine Vitamin K Available if 2.15 = ‘Yes’. Select all that apply. PCC = Prothrombin Complex Concentrate DOAC antidote = Direct Oral Anticoagulant antidote. Includes Idarucizumab, Andexanet alfa. FFP = Fresh Frozen Plasma Protamine Vitamin K 2.15.2 Data and time reversal agent was given. dd/mm/yyyy hh:mm Available if 2.15 = ‘Yes’. Time of of infusion If more than one reversal agent given, enter time of first reversal agent. Must be after time of arrival/onset of stroke for inpatients. 3.3a Date and time contact was first made with a stroke specialist consultant physician about this case (whether in person or otherwise) following a clinical assessment dd/mm/yyyy hh:mm No contact made Cannot be later than 72h after clock start. Enter the date and time of first contact with a stroke specialist consultant regarding this patient following a clinical assessment. The purpose of the clinical assessment is to make a decision about how the patient will be managed, and therefore this assessment needs to be undertaken by a competent professional trained in undertaking assessments of neurological patients. The assessment would normally include examination of the patient, taking a detailed history, and would take the results of the imaging into consideration. First contact with the consultant can be made in person, by telephone or via telemedicine (must include the option to view the patient via video if required). In scenarios where the paramedic had received specific training to undertake assessments of neurological patients, this first contact could be before the patient arrives at hospital.