CVA (Stroke)/Coma

Must have 1 and 2.

  1. Poor functional status with PPS[1] ≤40%
  2. Poor nutritional status withinability to maintain sufficient fluid and calorie intake with either:
    1. >10% weight loss over the previous (6) months
    2. >7.5% weight loss over the previous (3) months
    3. Serum albumin <2.5 gm/dl
    4. Current history of pulmonary aspiration without effective response to speech language pathology interventions to improve dysphagia and decrease aspiration events

Supporting evidence:

  • Coma (any etiology) with (3) of the following on the third day of coma:
    • Abnormal brain stem response
    • Absent verbal responses
    • Absent withdrawal response to pain
    • Serum creatinine >1.5gm/dl

[1] Refers to Palliative Performance Scale

See another guide:
Alzheimer’s/Dementia
Cancer
Heart Disease/CHF (Congestive Heart Failure)
HIV/AIDS
Huntington’s Disease
Liver Disease
Neurological Diseases (see list below)
      ALS (Amyotrophic Lateral Sclerosis)
      Parkinson’s
      Muscular Dystrophy
      Myasthenia Gravis
      MS (Multiple Sclerosis)
Pulmonary Disease/COPD (Chronic Obstructive Pulmonary Disease)
Renal (Kidney) Failure

Frequent Co-Morbidity documentation requirements
Cachexia/Protein Calorie Malnutrition (Weight Loss)

Referenced Tables 
Palliative Performance Scale (PPS)
New York Heart Association (NYHA) Functional Classes
Functional Assessment Staging (FAST) Scale

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