2021
National Trends in Telestroke Utilization in a US Commercial Platform Prior to the COVID-19 Pandemic
Zachrison KS, Sharma R, Wang Y, Mehrotra A, Schwamm LH. National Trends in Telestroke Utilization in a US Commercial Platform Prior to the COVID-19 Pandemic. Journal Of Stroke And Cerebrovascular Diseases 2021, 30: 106035. PMID: 34419836, PMCID: PMC8494566, DOI: 10.1016/j.jstrokecerebrovasdis.2021.106035.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCOVID-19Databases, FactualFemaleFibrinolytic AgentsHumansMaleMiddle AgedPractice Patterns, Physicians'Quality ImprovementQuality Indicators, Health CareRemote ConsultationStrokeThrombolytic TherapyTime FactorsTime-to-TreatmentTissue Plasminogen ActivatorTreatment OutcomeUnited StatesConceptsIschemic stroke patientsTelestroke consultationAlteplase deliveryStroke patientsNumber of patientsNumber of consultsCOVID-19 public health emergencyPublic health emergencyAlteplase useMedian doorNeedle timeStroke severityED arrivalEmergency departmentImaging reviewHospital characteristicsTelestroke networkCT scanHospital participationSpoke sitesProvider groupsPatientsHospital sizeStudy periodHealth emergency
2020
Target: Stroke Was Associated With Faster Intravenous Thrombolysis and Improved One-Year Outcomes for Acute Ischemic Stroke in Medicare Beneficiaries
Man S, Xian Y, Holmes D, Matsouaka R, Saver J, Smith E, Bhatt D, Schwamm L, Fonarow G. Target: Stroke Was Associated With Faster Intravenous Thrombolysis and Improved One-Year Outcomes for Acute Ischemic Stroke in Medicare Beneficiaries. Circulation Cardiovascular Quality And Outcomes 2020, 13: e007150. PMID: 33302714, DOI: 10.1161/circoutcomes.120.007150.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overDatabases, FactualFemaleFibrinolytic AgentsHumansInfusions, IntravenousInsurance BenefitsIschemic StrokeMaleMedicarePatient ReadmissionQuality ImprovementQuality Indicators, Health CareRetrospective StudiesRisk AssessmentRisk FactorsThrombolytic TherapyTime FactorsTime-to-TreatmentTreatment OutcomeUnited StatesConceptsAcute ischemic strokeIschemic strokeNeedle timeIntravenous thrombolysisCardiovascular readmissionCause mortalityThrombolytic treatmentThrombolytic therapyMedicare beneficiariesGuidelines-Stroke hospitalsIntravenous thrombolytic therapyIntravenous thrombolytic treatmentOne-year outcomesProportion of patientsProportional hazards analysisAmerican Heart AssociationQuality InitiativeCause readmissionMedian doorHospital clusteringMedian ageHeart AssociationHospital characteristicsReadmissionImproved doorAssociation Between Thrombolytic Door-to-Needle Time and 1-Year Mortality and Readmission in Patients With Acute Ischemic Stroke
Man S, Xian Y, Holmes D, Matsouaka R, Saver J, Smith E, Bhatt D, Schwamm L, Fonarow G. Association Between Thrombolytic Door-to-Needle Time and 1-Year Mortality and Readmission in Patients With Acute Ischemic Stroke. JAMA 2020, 323: 2170-2184. PMID: 32484532, PMCID: PMC7267850, DOI: 10.1001/jama.2020.5697.Peer-Reviewed Original ResearchConceptsIntravenous tissue plasminogen activatorAcute ischemic strokeTissue plasminogen activatorCause mortalityNeedle timeCause readmissionIschemic strokeLong-term outcomesShorter doorBetter long-term outcomesImproved long-term outcomesPlasminogen activatorRetrospective cohort studyGood functional outcomeGuidelines-StrokeCohort studyHospital arrivalHospital dischargeMedian doorEarly administrationMedian agePrimary outcomeThrombolytic therapyFunctional outcomeReadmission
2019
Components and Trends in Door to Treatment Times for Endovascular Therapy in Get With The Guidelines-Stroke Hospitals
Menon B, Xu H, Cox M, Saver J, Goyal M, Peterson E, Xian Y, Matsuoka R, Jehan R, Yavagal D, Gupta R, Mehta B, Bhatt D, Fonarow G, Schwamm L, Smith E. Components and Trends in Door to Treatment Times for Endovascular Therapy in Get With The Guidelines-Stroke Hospitals. Circulation 2019, 139: 169-179. PMID: 30586703, DOI: 10.1161/circulationaha.118.036701.Peer-Reviewed Original ResearchConceptsGuidelines-Stroke hospitalsEndovascular therapyHospital-level variablesShorter doorArterial accessCase volumeFirst pass timeArterial puncture timeComprehensive stroke centerLarge vessel occlusionCalendar year quarterWorkflow timesSignificant linear time trendsIschemic strokeLonger doorMedian doorStroke centersArterial punctureDiabetes mellitusMultivariable analysisPuncture timeFaster doorEmergency departmentClinical trialsMultivariable modeling
2018
Protocols for Endovascular Stroke Treatment Diminish the Weekend Effect Through Improvements in Off-Hours Care
Raymond S, Akbik F, Stapleton C, Mehta B, Chandra R, Gonzalez R, Rabinov J, Schwamm L, Patel A, Hirsch J, Leslie-Mazwi T. Protocols for Endovascular Stroke Treatment Diminish the Weekend Effect Through Improvements in Off-Hours Care. Frontiers In Neurology 2018, 9: 1106. PMID: 30619062, PMCID: PMC6305592, DOI: 10.3389/fneur.2018.01106.Peer-Reviewed Original ResearchTime of presentationTreatment latencyTreatment intervalEndovascular stroke treatmentProspective observational cohortOff-hour careAcute strokeMedian doorObservational cohortConsecutive patientsEndovascular therapyStroke treatmentStroke carePuncture timeFunctional outcomeProtocol adherenceThrombolysis candidatesInstitutional protocolPatient outcomesWeekend effectProtocol experienceStudy periodOutcomesPatientsRegular work hours
2016
Temporal Trends in Care and Outcomes of Patients Receiving Fibrinolytic Therapy Compared to Primary Percutaneous Coronary Intervention: Insights From the Get With The Guidelines Coronary Artery Disease (GWTG‐CAD) Registry
Hira R, Bhatt D, Fonarow G, Heidenreich P, Ju C, Virani S, Bozkurt B, Petersen L, Hernandez A, Schwamm L, Eapen Z, Albert M, Liang L, Matsouaka R, Peterson E, Jneid H. Temporal Trends in Care and Outcomes of Patients Receiving Fibrinolytic Therapy Compared to Primary Percutaneous Coronary Intervention: Insights From the Get With The Guidelines Coronary Artery Disease (GWTG‐CAD) Registry. Journal Of The American Heart Association 2016, 5: e004113. PMID: 27792640, PMCID: PMC5121508, DOI: 10.1161/jaha.116.004113.Peer-Reviewed Original ResearchMeSH KeywordsAgedCohort StudiesDatabases, FactualFemaleFibrinolytic AgentsGuideline AdherenceHospital MortalityHumansMaleMiddle AgedOutcome and Process Assessment, Health CarePercutaneous Coronary InterventionPractice Guidelines as TopicRegistriesST Elevation Myocardial InfarctionThrombolytic TherapyTime-to-TreatmentConceptsPrimary percutaneous coronary interventionST-elevation myocardial infarctionDefect-free careUse of fibrinolysisPercutaneous coronary interventionPCI-capable hospitalsNeedle timeHospital mortalitySTEMI patientsBalloon timeCoronary interventionMedian doorUse of PCIGuidelines-Coronary Artery Disease databaseGuidelines-Coronary Artery Disease registryCoronary Artery Disease registryHospital mortality outcomesOutcomes of patientsMinutes of arrivalPPCI patientsTimely reperfusionReperfusion therapyFibrinolytic therapyMortality outcomesMyocardial infarction
2014
Reducing Door‐to‐Puncture Times for Intra‐Arterial Stroke Therapy: A Pilot Quality Improvement Project
Mehta B, Leslie‐Mazwi T, Chandra R, Bell D, Sun C, Hirsch J, Rabinov J, Rost N, Schwamm L, Goldstein J, Levine W, Gupta R, Yoo A. Reducing Door‐to‐Puncture Times for Intra‐Arterial Stroke Therapy: A Pilot Quality Improvement Project. Journal Of The American Heart Association 2014, 3: e000963. PMID: 25389281, PMCID: PMC4338685, DOI: 10.1161/jaha.114.000963.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAnesthesia Department, HospitalCooperative BehaviorFemaleFibrinolytic AgentsHumansInfusions, Intra-ArterialInterdisciplinary CommunicationMaleMiddle AgedPatient Care TeamPilot ProjectsProcess Assessment, Health CareProgram EvaluationPuncturesQuality ImprovementQuality Indicators, Health CareRetrospective StudiesStrokeThrombectomyThrombolytic TherapyTime and Motion StudiesTime FactorsTime-to-TreatmentTreatment OutcomeWorkflowConceptsPilot quality improvement projectQuality improvement projectPuncture timeMedian doorStroke patientsAnterior circulation stroke patientsIntra-arterial stroke therapyHospital time delayPre-QI cohortCompletion of imagingImprovement projectGreater delayNeurointerventional suiteHospital delayProximal occlusionIndependent predictorsStroke therapyPatient evaluationQI measuresWorse outcomesTherapy leadTreatment decisionsAnesthesia teamPatient arrivalPatients
2012
Use of Tissue-Type Plasminogen Activator Before and After Publication of the European Cooperative Acute Stroke Study III in Get With The Guidelines-Stroke
Messé S, Fonarow G, Smith E, Kaltenbach L, Olson D, Kasner S, Schwamm L. Use of Tissue-Type Plasminogen Activator Before and After Publication of the European Cooperative Acute Stroke Study III in Get With The Guidelines-Stroke. Circulation Cardiovascular Quality And Outcomes 2012, 5: 321-326. PMID: 22550132, DOI: 10.1161/circoutcomes.111.964064.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overEuropeFemaleFibrinolytic AgentsGuideline AdherenceHumansInfusions, IntravenousLinear ModelsMaleMiddle AgedMultivariate AnalysisOdds RatioOutcome and Process Assessment, Health CarePractice Guidelines as TopicStrokeThrombolytic TherapyTime FactorsTissue Plasminogen ActivatorTreatment OutcomeUnited StatesConceptsAcute ischemic strokeEuropean Cooperative Acute Stroke Study (ECASS) IIIECASS IIITreatment of patientsUse of tPAEligible patientsHours of AISProportion of patientsStudy IIITissue-type plasminogen activatorGuidelines-StrokeIschemic strokeMedian doorNeedle timePatientsClinical practiceTreatment ratesPlasminogen activatorSignificant increaseHoursLater time windowAdverse affectsTPATreatmentProportion