2024
Deep learning survival model predicts outcome after intracerebral hemorrhage from initial CT scan.
Chen Y, Rivier C, Mora S, Torres Lopez V, Payabvash S, Sheth K, Harloff A, Falcone G, Rosand J, Mayerhofer E, Anderson C. Deep learning survival model predicts outcome after intracerebral hemorrhage from initial CT scan. European Stroke Journal 2024, 23969873241260154. PMID: 38880882, DOI: 10.1177/23969873241260154.Peer-Reviewed Original ResearchIntracerebral hemorrhage scoreNon-contrast CT scanIntracerebral hemorrhageCT scanFUNC scoreIntracerebral hemorrhage patientsNon-contrast CTFunctional impairmentSevere disabilityDependent living statusLong-term functional impairmentC-indexPrognostic toolFunctional outcomesTreatment decisionsAcute settingClinical implementationRehabilitation strategiesDependent livingPatientsPredicting functional impairmentLong-term care needsPlanning of patient careDeep learning modelsHemorrhageRadiomic Features of Acute Cerebral Hemorrhage on Non-Contrast CT Associated with Patient Survival
Zaman S, Dierksen F, Knapp A, Haider S, Karam G, Qureshi A, Falcone G, Sheth K, Payabvash S. Radiomic Features of Acute Cerebral Hemorrhage on Non-Contrast CT Associated with Patient Survival. Diagnostics 2024, 14: 944. PMID: 38732358, PMCID: PMC11083693, DOI: 10.3390/diagnostics14090944.Peer-Reviewed Original ResearchInternational Normalized RatioArea under the curveNational Institutes of Health Stroke ScaleIntracerebral hemorrhageRadiomic featuresAntihypertensive Treatment of Acute Cerebral Hemorrhage IINon-contrast head CT scanBaseline International Normalized RatioAssociated with worse survival outcomesAcute intracerebral hemorrhageSupratentorial intracerebral hemorrhageWorse survival outcomesKaplan-Meier analysisHead CT scanCox proportional hazards modelsPredictors of mortalityAcute cerebral hemorrhageReceiver Operating Characteristic (ROC) analysisFirst-order energyHigher mortality riskProportional hazards modelHealth Stroke ScaleCT radiomicsHematoma expansionPost-ICHChronic Kidney Disease and Risk of Intracerebral Hemorrhage: The Role of Hypertension as a Mediator (S34.004)
Vanent K, Rivier C, Matouk C, Levitt M, Leslie-Mazwi T, Gill T, Sheth K, Falcone G. Chronic Kidney Disease and Risk of Intracerebral Hemorrhage: The Role of Hypertension as a Mediator (S34.004). Neurology 2024, 102 DOI: 10.1212/wnl.0000000000205783.Peer-Reviewed Original ResearchOral Health as a Risk Factor for Spontaneous Intracerebral Hemorrhage: A Mendelian Randomization Analysis (S34.001)
Rivier C, Clocchiatti-Tuozzo S, Huo S, Renedo D, Hawkes M, Sunmonu N, Sheth K, Falcone G. Oral Health as a Risk Factor for Spontaneous Intracerebral Hemorrhage: A Mendelian Randomization Analysis (S34.001). Neurology 2024, 102 DOI: 10.1212/wnl.0000000000204999.Peer-Reviewed Original ResearchFactors Associated with Delayed Clinical Evaluation for Patients with Intracerebral Hemorrhage in the ERICH Study (S41.010)
Lalwani D, Zabinska J, Peasley E, De Havenon A, Falcone G, Goldstein J, Woo D, Sheth K. Factors Associated with Delayed Clinical Evaluation for Patients with Intracerebral Hemorrhage in the ERICH Study (S41.010). Neurology 2024, 102 DOI: 10.1212/wnl.0000000000204689.Peer-Reviewed Original ResearchDisparities in Healthcare Interactions After Intracerebral Hemorrhage: Evidence from the REDUCE Trial (P3-5.020)
Zabinska J, Taylor C, Peasley E, Lalwani D, Schwartz A, Falcone G, Sansing L, Arora R, Mena-Hurtado C, De Havenon A, Okpala M, Bushnell C, Mullen M, Cohen J, Cohen D, Messe S, Forman R, Sheth K. Disparities in Healthcare Interactions After Intracerebral Hemorrhage: Evidence from the REDUCE Trial (P3-5.020). Neurology 2024, 102 DOI: 10.1212/wnl.0000000000206241.Peer-Reviewed Original ResearchBurden of Ischemic and Hemorrhagic Stroke Across the US From 1990 to 2019
Renedo D, Acosta J, Leasure A, Sharma R, Krumholz H, de Havenon A, Alahdab F, Aravkin A, Aryan Z, Bärnighausen T, Basu S, Burkart K, Coberly K, Criqui M, Dai X, Desai R, Dharmaratne S, Doshi R, Elgendy I, Feigin V, Filip I, Gad M, Ghozy S, Hafezi-Nejad N, Kalani R, Karaye I, Kisa A, Krishnamoorthy V, Lo W, Mestrovic T, Miller T, Misganaw A, Mokdad A, Murray C, Natto Z, Radfar A, Ram P, Roth G, Seylani A, Shah N, Sharma P, Sheikh A, Singh J, Song S, Sotoudeh H, Vervoort D, Wang C, Xiao H, Xu S, Zand R, Falcone G, Sheth K. Burden of Ischemic and Hemorrhagic Stroke Across the US From 1990 to 2019. JAMA Neurology 2024, 81: 394-404. PMID: 38436973, PMCID: PMC10913004, DOI: 10.1001/jamaneurol.2024.0190.Peer-Reviewed Original ResearchBurden of strokeHemorrhagic strokeBurden trendsGlobal burdenGlobal Burden of Disease StudyBurden of Disease StudyAge-standardized ratesAge-standardized estimatesPublic health policiesStroke-related outcomesIschemic strokeCross-sectional studyPublic health challengeCross-sectional analysisStroke mortalityStroke burdenHealth policyOlder adultsMain OutcomesStroke incidenceStroke casesIntracerebral hemorrhageEscalating burdenHealth challengesSignificant disparitiesTime to Anticoagulation Reversal and Outcomes After Intracerebral Hemorrhage
Sheth K, Solomon N, Alhanti B, Messe S, Xian Y, Bhatt D, Hemphill J, Frontera J, Chang R, Danelich I, Huang J, Schwamm L, Smith E, Goldstein J, Mac Grory B, Fonarow G, Saver J. Time to Anticoagulation Reversal and Outcomes After Intracerebral Hemorrhage. JAMA Neurology 2024, 81: 363-372. PMID: 38335064, PMCID: PMC11002694, DOI: 10.1001/jamaneurol.2024.0221.Peer-Reviewed Original ResearchDoor-to-treatment timeDoor-to-treatmentUS hospitalsQuality improvement registryOnset-to-treatment timeAmerican Heart AssociationFunctional outcomesLogistic regression modelsAssociated with decreased mortalityGuidelines-StrokeIntracerebral hemorrhageHospital characteristicsImprovement registryIntervention statusMain OutcomesAnticoagulation-associated intracerebral hemorrhageSystolic blood pressureInpatient mortalityRandom interceptCohort studyWhite raceSecondary outcomesStroke subtypesStroke severityWorkflow timesUncertainty-aware deep-learning model for prediction of supratentorial hematoma expansion from admission non-contrast head computed tomography scan
Tran A, Zeevi T, Haider S, Abou Karam G, Berson E, Tharmaseelan H, Qureshi A, Sanelli P, Werring D, Malhotra A, Petersen N, de Havenon A, Falcone G, Sheth K, Payabvash S. Uncertainty-aware deep-learning model for prediction of supratentorial hematoma expansion from admission non-contrast head computed tomography scan. Npj Digital Medicine 2024, 7: 26. PMID: 38321131, PMCID: PMC10847454, DOI: 10.1038/s41746-024-01007-w.Peer-Reviewed Original ResearchDeep learning modelsHematoma expansionIntracerebral hemorrhageICH expansionComputed tomographyNon-contrast head CTNon-contrast head computed tomographyHigh risk of HEHead computed tomographyHigh-confidence predictionsRisk of HENon-contrast headReceiver operating characteristic areaModifiable risk factorsMonte Carlo dropoutOperating characteristics areaPotential treatment targetHead CTVisual markersIdentified patientsAutomated deep learning modelDataset of patientsRisk factorsHigh riskPatientsAPOE ε4 and Intracerebral Hemorrhage in Patients With Brain Arteriovenous Malformation
Renedo D, Rivier C, Koo A, Sujijantarat N, Clocchiatti-Tuozzo S, Wu K, Torres-Lopez V, Huo S, Gunel M, de Havenon A, Sheth K, Matouk C, Falcone G. APOE ε4 and Intracerebral Hemorrhage in Patients With Brain Arteriovenous Malformation. JAMA Network Open 2024, 7: e2355368. PMID: 38363572, PMCID: PMC10873768, DOI: 10.1001/jamanetworkopen.2023.55368.Peer-Reviewed Original ResearchConceptsApolipoprotein E e4Participants of European ancestryRisk of intracerebral hemorrhageHigh risk of intracerebral hemorrhageCross-sectional studyUK BiobankEuropean ancestryHigh riskUs Research ProgramUK Biobank participantsInternational Classification of DiseasesAssociated with higher risk of ICHCross-sectional study of patientsAPOE e4 statusClassification of DiseasesApolipoprotein ENinth Revision and Tenth RevisionAssociated with higher riskIndividual-level dataMultivariate logistic regressionIntracerebral hemorrhage riskBrain arteriovenous malformationsIntracerebral hemorrhageBiobank participantsTenth RevisionCerebral Amyloid Angiopathy and Risk of Isolated Nontraumatic Subdural Hemorrhage
Rivier C, Kamel H, Sheth K, Iadecola C, Gupta A, de Leon M, Ross E, Falcone G, Murthy S. Cerebral Amyloid Angiopathy and Risk of Isolated Nontraumatic Subdural Hemorrhage. JAMA Neurology 2024, 81: 163-169. PMID: 38147345, PMCID: PMC10751656, DOI: 10.1001/jamaneurol.2023.4918.Peer-Reviewed Original ResearchCerebral amyloid angiopathyMultivariable logistic regression analysisSubdural hemorrhageLogistic regression analysisIntracerebral hemorrhageIntracranial hemorrhageUK Biobank cohortAmyloid angiopathyMean ageUS cohortRisk factorsHigher oddsDiagnosis of CAAPopulation-based cohort studyBiobank cohortClinical Modification diagnosis codesCAA-related intracerebral hemorrhageCox proportional hazards modelRegression analysisAntithrombotic medication useIndependent risk factorCox regression analysisMultivariable logistic regressionNovel risk factorsSpontaneous intracerebral hemorrhageAssociation Between Hematoma Volume and Risk of Subsequent Ischemic Stroke: A MISTIE III and ATACH-2 Analysis
Harris W, Kaiser J, Liao V, Avadhani R, Iadecola C, Falcone G, Sheth K, Qureshi A, Goldstein J, Awad I, Hanley D, Kamel H, Ziai W, Murthy S. Association Between Hematoma Volume and Risk of Subsequent Ischemic Stroke: A MISTIE III and ATACH-2 Analysis. Stroke 2024, 55: 541-547. PMID: 38299346, PMCID: PMC10932908, DOI: 10.1161/strokeaha.123.045859.Peer-Reviewed Original ResearchConceptsIntracerebral hemorrhage volumeMedian ICH volumeRisk of ischemic strokeHematoma volumeIntracerebral hemorrhageIncreased risk of ischemic strokeATACH-2ICH volumeIschemic strokeCumulative incidenceMISTIE IIIIncreased riskLong-term increased riskIntracerebral hemorrhage characteristicsMedian hematoma volumeHeterogeneous cohort of patientsMedian follow-upPrimary analysisIntracerebral hemorrhage locationCohort of patientsNontraumatic intracerebral hemorrhageCox regression analysisShort-term risk of ischemic strokeCox regression modelsIndividual patient dataCOVID‐19 Infection Is Associated With Poor Outcomes in Patients With Intracerebral Hemorrhage
Renedo D, Leasure A, Young R, Rivier C, Alhanti B, Mac Grory B, Messe S, Reeves M, Hassan A, Schwamm L, de Havenon A, Matouk C, Sheth K, Falcone G. COVID‐19 Infection Is Associated With Poor Outcomes in Patients With Intracerebral Hemorrhage. Journal Of The American Heart Association 2024, 13: e030999. PMID: 38293940, PMCID: PMC11056169, DOI: 10.1161/jaha.123.030999.Peer-Reviewed Original ResearchConceptsOdds of poor outcomeIntracerebral hemorrhageCOVID-19 infectionPoor outcomeHealth care deliverySkilled nursing facilityMultivariate analysisOdds of mortalityConcomitant COVID-19 infectionAssociated with poor outcomesCare deliveryNursing facilitiesPoor functional outcomeCOVID-19OddsICH outcomeImpact of COVID-19No significant differenceObservational studyHemorrhagic strokeWorsen outcomesPatient populationFunctional outcomesStroke dataPatientsTime-Dependent Changes in Hematoma Expansion Rate after Supratentorial Intracerebral Hemorrhage and Its Relationship with Neurological Deterioration and Functional Outcome
Karam G, Chen M, Zeevi D, Harms B, Torres-Lopez V, Rivier C, Malhotra A, de Havenon A, Falcone G, Sheth K, Payabvash S. Time-Dependent Changes in Hematoma Expansion Rate after Supratentorial Intracerebral Hemorrhage and Its Relationship with Neurological Deterioration and Functional Outcome. Diagnostics 2024, 14: 308. PMID: 38337824, PMCID: PMC10855868, DOI: 10.3390/diagnostics14030308.Peer-Reviewed Original ResearchPredictors of NDSupratentorial intracerebral hemorrhageHematoma expansionIntracerebral hemorrhageNeurological deteriorationPoor outcomeNIH Stroke ScalePost-ICHFunctional outcomesMild symptomsHematoma expansion ratesIntracerebral hemorrhage onsetAssociation of HEModifiable risk factorsGlasgow Coma ScaleBaseline CTHematoma growthConsecutive patientsHead CTSCAN-3Follow-upRate of HEComa ScaleRisk factorsHematomaPeri-hematomal edema shape features related to 3-month outcome in acute supratentorial intracerebral hemorrhage
Dierksen F, Tran A, Zeevi T, Maier I, Qureshi A, Sanelli P, Werring D, Malhotra A, Falcone G, Sheth K, Payabvash S. Peri-hematomal edema shape features related to 3-month outcome in acute supratentorial intracerebral hemorrhage. European Stroke Journal 2024, 9: 383-390. PMID: 38179883, PMCID: PMC11318427, DOI: 10.1177/23969873231223814.Peer-Reviewed Original ResearchNIH Stroke ScaleGlasgow Coma ScaleAssociation of baselineIntracerebral hemorrhagePerihematomal edemaHematoma volumeAcute supratentorial intracerebral hemorrhageNon-traumatic intracerebral hemorrhageSecondary brain injuryAcute ICH patientsIndependent prognostic factorSupratentorial intracerebral hemorrhageAdmission NIH Stroke ScalePotential treatment targetRankin scoreStroke ScaleIndependent predictorsPatient agePrognostic factorsComa ScaleMultivariable analysisICH patientsPrognostic valueBrain injuryFavorable outcome
2023
Code ICH: A Call to Action
Li Q, Yakhkind A, Alexandrov A, Alexandrov A, Anderson C, Dowlatshahi D, Frontera J, Hemphill J, Ganti L, Kellner C, May C, Morotti A, Parry-Jones A, Sheth K, Steiner T, Ziai W, Goldstein J, Mayer S. Code ICH: A Call to Action. Stroke 2023, 55: 494-505. PMID: 38099439, DOI: 10.1161/strokeaha.123.043033.Peer-Reviewed Original ResearchIntracerebral hemorrhageHematoma expansionNeurological outcomeEarly aggressive careAcute ischemic strokeBlood pressure controlPoor functional outcomeMultiple simultaneous interventionsBundled careAggressive careIschemic strokeIndependent predictorsPrimary outcomeAcute phaseEmergency reversalFunctional recoveryRandomized trialsFunctional outcomeWorse outcomesConsensus statementCurrent evidenceTreatment opportunitiesSingle interventionEarly interventionPressure controlAntithrombotic and Statin Prescription After Intracerebral Hemorrhage in the Get With The Guidelines-Stroke Registry
Murthy S, Zhang C, Shah S, Schwamm L, Fonarow G, Smith E, Bhatt D, Ziai W, Kamel H, Sheth K. Antithrombotic and Statin Prescription After Intracerebral Hemorrhage in the Get With The Guidelines-Stroke Registry. Stroke 2023, 54: 2972-2980. PMID: 37942641, PMCID: PMC10842167, DOI: 10.1161/strokeaha.123.043194.Peer-Reviewed Original ResearchConceptsIschemic vascular diseaseProportion of patientsGuidelines-Stroke registryLipid-lowering therapyIntracerebral hemorrhageVascular diseaseStatin therapyAnticoagulation therapyCardiovascular eventsAtrial fibrillationFuture major cardiovascular eventsLower admission National InstitutesPrevious lipid-lowering therapyAdmission National InstitutesFavorable discharge outcomeIschemic cardiovascular eventsHealth Stroke ScaleMajor cardiovascular eventsLipid-lowering medicationsCross-sectional studyMultiple logistic regressionLogistic regression analysisAntiplatelet medicationsAntiplatelet therapyStatin medicationDetection of Intracerebral Hemorrhage Using Low-Field, Portable Magnetic Resonance Imaging in Patients With Stroke
Mazurek M, Parasuram N, Peng T, Beekman R, Yadlapalli V, Sorby-Adams A, Lalwani D, Zabinska J, Gilmore E, Petersen N, Falcone G, Sujijantarat N, Matouk C, Payabvash S, Sze G, Schiff S, Iglesias J, Rosen M, de Havenon A, Kimberly W, Sheth K. Detection of Intracerebral Hemorrhage Using Low-Field, Portable Magnetic Resonance Imaging in Patients With Stroke. Stroke 2023, 54: 2832-2841. PMID: 37795593, PMCID: PMC11103256, DOI: 10.1161/strokeaha.123.043146.Peer-Reviewed Original ResearchConceptsMagnetic resonance imagingIntracerebral hemorrhageClinical informationYale-New Haven HospitalIntensive Blood Pressure Reduction is Associated with Reduced Hematoma Growth in Fast Bleeding Intracerebral Hemorrhage
Li Q, Morotti A, Warren A, Qureshi A, Dowlatshahi D, Falcone G, Sheth K, Shoamanesh A, Murthy S, Viswanathan A, Goldstein J. Intensive Blood Pressure Reduction is Associated with Reduced Hematoma Growth in Fast Bleeding Intracerebral Hemorrhage. Annals Of Neurology 2023, 95: 129-136. PMID: 37706569, DOI: 10.1002/ana.26795.Peer-Reviewed Original ResearchBlood pressure reductionIntensive Blood Pressure ReductionIntensive BP reductionIntracerebral hemorrhageHematoma growthBP reductionPressure reductionImproved functional independenceIntensive BP loweringLarge clinical trialsSpontaneous intracerebral hemorrhageAntihypertensive treatmentHemorrhage 2BP loweringSymptom onsetHematoma volumeHematoma expansionClinical trialsHigh riskTomography timePatientsFunctional independenceEarly useHemorrhageLower ratesClinical implications of Peri-hematomal edema microperfusion fraction in intracerebral hemorrhage intravoxel incoherent motion imaging – A pilot study
Abou Karam G, Tharmaseelan H, Aboian M, Malhotra A, Gilmore E, Falcone G, de Havenon A, Sheth K, Payabvash S. Clinical implications of Peri-hematomal edema microperfusion fraction in intracerebral hemorrhage intravoxel incoherent motion imaging – A pilot study. Journal Of Stroke And Cerebrovascular Diseases 2023, 32: 107375. PMID: 37738914, PMCID: PMC10591892, DOI: 10.1016/j.jstrokecerebrovasdis.2023.107375.Peer-Reviewed Original ResearchConceptsModified Rankin ScaleSecondary brain injuryIntracerebral hemorrhagePerihematomal edemaSubacute intracerebral hemorrhageIntravoxel incoherent motion imagingAdmission NIHSSBrain injuryMedian baseline National InstitutesPilot studyBaseline National InstitutesHealth Stroke ScalePerfusion fractionSupratentorial intracerebral hemorrhageIVIM metricsIncoherent motion imagingStroke ScaleNeuroprotective therapiesParenchymal injuryRankin ScaleRisk patientsConsecutive patientsUnivariable analysisPoor outcomeICH volume