2022
Top Ten Tips Palliative Care Clinicians Should Know About Disorders of Consciousness: A Focus on Traumatic and Anoxic Brain Injury
Steinberg A, Hudoba C, Hwang DY, Kramer NM, Mehta AK, Muehlschlegel S, Jones CA, Besbris J. Top Ten Tips Palliative Care Clinicians Should Know About Disorders of Consciousness: A Focus on Traumatic and Anoxic Brain Injury. Journal Of Palliative Medicine 2022, 25: 1571-1578. PMID: 35639356, DOI: 10.1089/jpm.2022.0202.Peer-Reviewed Original ResearchStressors Experienced by Primary Caregivers of Severe Acute Brain Injury Patients Recovering from Coma in Neurointensive Care Units: Preliminary Findings from a Multicenter Qualitative Study (P1-4.009)
Meurer K, Kubota R, Baskaran N, Zhang Q, Bannon S, Fishbein N, Reichman M, Popok P, Lester E, Motta M, Muehlschlegel S, Reznik M, Jaffa M, Creutzfeldt C, Fehnel C, Williamson C, Vranceanu A, Hwang D, Investigators C. Stressors Experienced by Primary Caregivers of Severe Acute Brain Injury Patients Recovering from Coma in Neurointensive Care Units: Preliminary Findings from a Multicenter Qualitative Study (P1-4.009). Neurology 2022, 98 DOI: 10.1212/wnl.98.18_supplement.3641.Peer-Reviewed Original Research
2021
A Two-Center, Parallel-Arm Randomized-Controlled Feasibility Trial Of A Goals-Of-Care Decision Aid For Surrogates Of Severe Acute Brain Injury Patients (2288)
Muehlschlegel S, Goostrey K, Flahive J, Zhang Q, Pach J, Hwang D. A Two-Center, Parallel-Arm Randomized-Controlled Feasibility Trial Of A Goals-Of-Care Decision Aid For Surrogates Of Severe Acute Brain Injury Patients (2288). Neurology 2021, 96 DOI: 10.1212/wnl.96.15_supplement.2288.Peer-Reviewed Original ResearchLow-Field, Portable Magnetic Resonance Imaging at the Bedside to Assess Brain Injury in Patients with Severe COVID-19 (1349)
Mazurek M, Yuen M, Cahn B, Rosen M, Gobeske K, Gilmore E, Hwang D, Kaddouh F, Kim J, Falcone G, Petersen N, Siner J, Spudich S, Sze G, Kimberly W, Sheth K. Low-Field, Portable Magnetic Resonance Imaging at the Bedside to Assess Brain Injury in Patients with Severe COVID-19 (1349). Neurology 2021, 96 DOI: 10.1212/wnl.96.15_supplement.1349.Peer-Reviewed Original ResearchPredictors of Family Dissatisfaction with Support During Neurocritical Care Shared Decision-Making
Weber U, Zhang Q, Ou D, Garritano J, Johnson J, Anderson N, Knies AK, Nhundu B, Bautista C, Huang KB, Vranceanu AM, Rosand J, Hwang DY. Predictors of Family Dissatisfaction with Support During Neurocritical Care Shared Decision-Making. Neurocritical Care 2021, 35: 714-722. PMID: 33821402, PMCID: PMC8021441, DOI: 10.1007/s12028-021-01211-6.Peer-Reviewed Original ResearchConceptsFormal family meetingsICU admissionFamily meetingsNeuro-ICURetrospective observational cohort studyObservational cohort studyUS academic centersFamilies of patientsBroad inclusion criteriaFamily satisfactionTop-box responsesFamily membersNeuroscience ICUICU dischargeICU courseCohort studyIll patientsAvailable patientsPatient variablesFamily dissatisfactionInclusion criteriaPatientsAcademic centersPatient lengthAverage patient length
2020
US Practitioner Attitudes Toward Tracheostomy Timing, Benefits, Risks, and Techniques for Severe Stroke Patients: A National Survey and National Inpatient Sample Analysis
Zhao CW, Hwang DY. US Practitioner Attitudes Toward Tracheostomy Timing, Benefits, Risks, and Techniques for Severe Stroke Patients: A National Survey and National Inpatient Sample Analysis. Neurocritical Care 2020, 34: 669-673. PMID: 33094469, DOI: 10.1007/s12028-020-01127-7.Peer-Reviewed Original ResearchThe impact of delirium on withdrawal of life-sustaining treatment after intracerebral hemorrhage.
Reznik ME, Moody S, Murray K, Costa S, Grory BM, Madsen TE, Mahta A, Wendell LC, Thompson BB, Rao SS, Stretz C, Sheth KN, Hwang DY, Zahuranec DB, Schrag M, Daiello LA, Asaad WF, Jones RN, Furie KL. The impact of delirium on withdrawal of life-sustaining treatment after intracerebral hemorrhage. Neurology 2020, 95: e2727-e2735. PMID: 32913011, PMCID: PMC7734724, DOI: 10.1212/wnl.0000000000010738.Peer-Reviewed Original ResearchConceptsImpact of deliriumIntracerebral hemorrhageLife-sustaining treatmentScore-based modelSingle-center cohort studyCox regression modelCharacteristic curve analysisDSM-5 criteriaHospital daysCohort studyConsecutive patientsMedian timeDelirium groupPoor outcomeDeliriumWLSTPatientsLogistic regressionCurve analysisHemorrhagePsychological Attachment Orientations of Surrogate Decision-Makers and Goals-of-Care Decisions for Brain Injury Patients in ICUs
Knies AK, Zhang Q, Juthani P, Tu S, Pach J, Martinez A, Monin JK, Hwang DY. Psychological Attachment Orientations of Surrogate Decision-Makers and Goals-of-Care Decisions for Brain Injury Patients in ICUs. Critical Care Explorations 2020, 2: e0151. PMID: 32696015, PMCID: PMC7340333, DOI: 10.1097/cce.0000000000000151.Peer-Reviewed Original ResearchLife-sustaining therapyBrain injury patientsAcute brain injury patientsInjury patientsTherapy selectionNonwhite racePoor prognosisFisher's exact testAcademic medical centerCross-sectional surveyNeuroscience ICUPatient demographicsIndependent predictorsMedical CenterComfort measuresExact testConsecutive samplePatientsEligible respondentsTherapyICUCare decisionsFuture interventionsMultivariate modelSignificant predictorsGoals-of-care decision aid for critically ill patients with TBI: Development and feasibility testing.
Muehlschlegel S, Hwang DY, Flahive J, Quinn T, Lee C, Moskowitz J, Goostrey K, Jones K, Pach JJ, Knies AK, Shutter L, Goldberg R, Mazor KM. Goals-of-care decision aid for critically ill patients with TBI: Development and feasibility testing. Neurology 2020, 95: e179-e193. PMID: 32554766, PMCID: PMC7455326, DOI: 10.1212/wnl.0000000000009770.Peer-Reviewed Original ResearchConceptsCare decision aidSurrogates of patientsEarly feasibilityFeasibility trial protocolTraumatic brain injuryDecision aidConsecutive patientsIll patientsFeasibility trialStudy protocolTrial protocolBrain injuryInterim analysisCare communicationPatientsPaper-based decision aidExcellent usabilityComplete dataFeasibility testingHigh rateFamily membersBehavioral outcomesQualitative studyAcceptabilityIterative revisionsConcerns of surrogate decision makers for patients with acute brain injury: A US population survey.
Hwang DY, Knies AK, Mampre D, Kolenikov S, Schalk M, Hammer H, White DB, Holloway RG, Sheth KN, Fraenkel L. Concerns of surrogate decision makers for patients with acute brain injury: A US population survey. Neurology 2020, 94: e2054-e2068. PMID: 32341190, PMCID: PMC7282883, DOI: 10.1212/wnl.0000000000009406.Peer-Reviewed Original ResearchConceptsSevere acute brain injurySevere functional disabilityAcute brain injurySurrogate decision makersBrain injuryLatent class analysisPatient's wishesVegetative stateLong-term careFunctional disabilityPoor prognosisUS population surveySD groupPrognostic accuracyHypothetical patientsPatientsUS populationAdditional groupOlder adultsFuture interventionsCompletion ratesInjuryFamily consensusPopulation surveyUnique concerns
2019
Promoting Family Engagement in the ICU: Experience From a National Collaborative of 63 ICUs.
Kleinpell R, Zimmerman J, Vermoch KL, Harmon LA, Vondracek H, Hamilton R, Hanson B, Hwang DY. Promoting Family Engagement in the ICU: Experience From a National Collaborative of 63 ICUs. Critical Care Medicine 2019, 47: 1692-1698. PMID: 31567354, DOI: 10.1097/ccm.0000000000004009.Peer-Reviewed Original ResearchConceptsICU teamFamily satisfactionNational collaborativeFamily advisory committeeOverall family satisfactionFamily advisory groupsQuality of careFamily membersICU 24Family engagementClinician surveyNational PatientFamily member involvementPICU teamCare teamCommunity hospitalClinicians' perceptionsOpen visitationPatientsClinical settingICUSignificant increaseSelf-Assessment InventoryHospitalAdvisory Committee
2018
Prognostication
Mac Grory B, Hwang D. Prognostication. 2018, 161-170. DOI: 10.1007/978-3-319-93215-6_12.Peer-Reviewed Original ResearchNeurologic patientsDisease-directed treatmentFuture functional statusGoals of carePatient-centered goalsQuality of lifeObjective outcome dataFunctional statusPatient prognosisOutcome dataDisease processPrognosisPrognostic uncertaintyAccurate prognosisPatientsPrognostic estimatesEventual deathSerious newsTreatmentPotential pitfallsNeurologistsSubjective impressionsPrognosticationCliniciansHospiceNeuropalliative care
Creutzfeldt CJ, Kluger B, Kelly AG, Lemmon M, Hwang DY, Galifianakis NB, Carver A, Katz M, Curtis JR, Holloway RG. Neuropalliative care. Neurology 2018, 91: 217-226. PMID: 29950434, PMCID: PMC6093769, DOI: 10.1212/wnl.0000000000005916.Peer-Reviewed Original ResearchConceptsPalliative careNeuropalliative careNeurologic illnessComplex symptom managementModel of carePalliative care educationQuality of carePalliative approachPalliative specialistsSymptom managementClinical priorityPatientsInterventional researchEvidence baseCareCare educationImplementation scienceNeurologistsIllnessInternational expertsNeurologyFamily engagementImportant outcomesOutcomesInvestigative effortsHistory of Intracranial Hemorrhage Is Associated with In-Hospital Mortality in Ischemic Stroke Patients Treated with Intravenous Thrombolytics
Sommaruga S, Chu S, Hwang D, Dearborn J, Sansing L, Cord B, Santarosa C, Samarth G, Petersen N, Gilmore E, Schindler J, Bijlenga P, Schaller K, Matouk C, Sheth K, Falcone G. History of Intracranial Hemorrhage Is Associated with In-Hospital Mortality in Ischemic Stroke Patients Treated with Intravenous Thrombolytics. Journal Of Neurological Surgery Part A Central European Neurosurgery 2018, 79: s1-s27. DOI: 10.1055/s-0038-1660745.Peer-Reviewed Original ResearchCharacteristics of Surrogate Decision Makers Selecting Life-sustaining Therapy for Severe Intracerebral Hemorrhage Patients: a Neuropalliative Care Survey of the US Population (S7.003)
Hwang D, Knies A, White D, Holloway R, Sheth K, Fraenkel L. Characteristics of Surrogate Decision Makers Selecting Life-sustaining Therapy for Severe Intracerebral Hemorrhage Patients: a Neuropalliative Care Survey of the US Population (S7.003). Neurology 2018, 90 DOI: 10.1212/wnl.90.15_supplement.s7.003.Peer-Reviewed Original ResearchSafety Outcomes of Thrombolysis for Acute Ischemic Stroke in Patients with History of Intracranial Hemorrhage (P4.033)
Chu S, Sommaruga S, Hwang D, Dearborn J, Sansing L, Cord B, Samarth G, Petersen N, Gilmore E, Schindler J, Matouk C, Sheth K, Falcone G. Safety Outcomes of Thrombolysis for Acute Ischemic Stroke in Patients with History of Intracranial Hemorrhage (P4.033). Neurology 2018, 90 DOI: 10.1212/wnl.90.15_supplement.p4.033.Peer-Reviewed Original ResearchDedicated Afternoon Rounds for ICU Patients’ Families and Family Satisfaction With Care
Weber U, Johnson J, Anderson N, Knies AK, Nhundu B, Bautista C, Huang KB, Hamza M, White J, Coppola A, Akgün KM, Greer DM, Marcolini EG, Gilmore EJ, Petersen NH, Timario N, Poskus K, Sheth KN, Hwang DY. Dedicated Afternoon Rounds for ICU Patients’ Families and Family Satisfaction With Care. Critical Care Medicine 2018, 46: 602-611. PMID: 29300237, DOI: 10.1097/ccm.0000000000002963.Peer-Reviewed Original ResearchConceptsOverall family satisfactionNeuroscience ICUFamily satisfactionCoordination of careAfternoon roundsICU admissionPrimary outcomeICU patientsBedside visitsMean prePostimplementation designComfort measuresPatient's familySecondary analysisICUPatientsCareNursing leadersScoresFamily supportFamily membersWeeksEmotional supportPreComplete satisfactionPrimary Care Physician Involvement in Shared Decision Making for Critically Ill Patients and Family Satisfaction with Care
Huang KB, Weber U, Johnson J, Anderson N, Knies AK, Nhundu B, Bautista C, Poskus K, Sheth KN, Hwang DY. Primary Care Physician Involvement in Shared Decision Making for Critically Ill Patients and Family Satisfaction with Care. The Journal Of The American Board Of Family Medicine 2018, 31: 64-72. PMID: 29330241, DOI: 10.3122/jabfm.2018.01.170211.Peer-Reviewed Original ResearchConceptsPatient's primary care physicianPatient's PCPPrimary care physiciansIll patientsPCP involvementPrimary care physician involvementMedical decisionsFamilies of patientsFamily satisfactionICU decisionICU patientsCare physiciansClinical informationPatientsMedical teamSatisfaction scoresIndividual survey itemsPhysician involvementICUMean scoreInvolvementFamily membersCareScoresSurvey items
2017
Variability in Gastrostomy Tube Placement for Intracerebral Hemorrhage Patients at US Hospitals
Hwang DY, George BP, Kelly AG, Schneider EB, Sheth KN, Holloway RG. Variability in Gastrostomy Tube Placement for Intracerebral Hemorrhage Patients at US Hospitals. Journal Of Stroke And Cerebrovascular Diseases 2017, 27: 978-987. PMID: 29221969, DOI: 10.1016/j.jstrokecerebrovasdis.2017.11.001.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overCerebral HemorrhageClinical Decision-MakingDatabases, FactualFemaleGastrostomyHealthcare DisparitiesHospitalsHumansLogistic ModelsMaleMiddle AgedMultivariate AnalysisOdds RatioPractice Patterns, Physicians'Process Assessment, Health CareRetrospective StudiesTime FactorsUnited StatesYoung AdultConceptsGastrostomy tube placementTube placementGastrostomy tubeICH patientsIntracerebral hemorrhageUS hospitalsMultilevel multivariable regression modelsHospital random effectsNationwide Inpatient SampleIntracerebral hemorrhage patientsMultivariable regression modelsLocal practice patternsMedian odds ratioICH hospitalizationsHospital factorsHospital covariatesRegression modelsHemorrhage patientsICH admissionsInpatient SampleOdds ratioPlacement ratesPractice patternsMedian increasePatientsGoals of Care and Difficult Conversations
Hudoba C, Hwang D. Goals of Care and Difficult Conversations. 2017, 343-361. DOI: 10.1007/978-3-319-48669-7_19.Peer-Reviewed Original Research