2022
No short-term mortality from benzodiazepine use post-acute ischemic stroke after accounting for bias
Moura L, Yan Z, Donahue M, Smith L, Schwamm L, Hsu J, Newhouse J, Haneuse S, Blacker D, Hernandez-Diaz S. No short-term mortality from benzodiazepine use post-acute ischemic stroke after accounting for bias. Journal Of Clinical Epidemiology 2022, 154: 136-145. PMID: 36572369, PMCID: PMC10033385, DOI: 10.1016/j.jclinepi.2022.12.013.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeRisk differenceIschemic strokeBenzodiazepine useShort-term mortalityImmortal time biasElectronic health recordsAIS admissionsBenzodiazepine initiationStroke RegistryPoststroke mortalityTreatment initiationMortality riskPatientsFurther adjustmentMortalityBenzodiazepinesOlder adultsTime biasHealth recordsImmortal timeStrokeRiskDaysContraindicationsDevelopment and validation of the age-associated dementia policy (AgeD-Pol) computer simulation model in the USA and Europe
Hyle E, Foote J, Shebl F, Qian Y, Reddy K, Mukerji S, Wattananimitgul N, Viswanathan A, Schwamm L, Pandya A, Freedberg K. Development and validation of the age-associated dementia policy (AgeD-Pol) computer simulation model in the USA and Europe. BMJ Open 2022, 12: e056546. PMID: 35793913, PMCID: PMC9260808, DOI: 10.1136/bmjopen-2021-056546.Peer-Reviewed Original ResearchConceptsAge-associated dementiaKaiser Permanente Northern CaliforniaCumulative incidenceAAD incidenceInternal validationLifetime cumulative incidenceSex-stratified dataExternal validationFramingham Heart StudyCohort studyRotterdam StudyRotterdam cohortDisease burdenDisease progressionOutcome measuresHeart StudyDATA SOURCESACT cohortAdult ChangesCohort dataNatural historyCohortMortalityHealth systemIncidence
2020
Antiplatelet patterns and outcomes in patients with atrial fibrillation not prescribed an anticoagulant after stroke
Chang K, Xian Y, Zhao X, Mi X, Matsouaka R, Schwamm L, Shah S, Lytle B, Smith E, Bhatt D, Fonarow G, Hsu J. Antiplatelet patterns and outcomes in patients with atrial fibrillation not prescribed an anticoagulant after stroke. International Journal Of Cardiology 2020, 321: 88-94. PMID: 32805327, DOI: 10.1016/j.ijcard.2020.08.011.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeAntiplatelet therapyAntithrombotic therapyIschemic strokeTherapy prescriptionOral anticoagulationUnadjusted ratesGuidelines-Stroke registryService beneficiaries 65Retrospective cohort studyOral anticoagulant therapyAnticoagulant therapyCohort studyComposite endpointPrimary outcomeAtrial fibrillationAtrial flutterPotential confoundersNeurologic/Medicare beneficiariesMedicare feeTherapyStrokePatientsMortality
2018
Factors associated with 1-year mortality after discharge for acute stroke: what matters?
Magdon-Ismail Z, Ledneva T, Sun M, Schwamm L, Sherman B, Qian F, Bettger J, Xian Y, Stein J. Factors associated with 1-year mortality after discharge for acute stroke: what matters? Topics In Stroke Rehabilitation 2018, 25: 576-583. PMID: 30281414, DOI: 10.1080/10749357.2018.1499303.Peer-Reviewed Original ResearchConceptsInpatient rehabilitation facilitySkilled nursing facilitiesAcute strokeDischarge destinationHealth Stroke ScaleHigher National InstitutesRetrospective cohort studyLong-term outcomesLong-term survivalCause mortalityStroke ScaleCohort studyIschemic strokeAmbulation statusIntracerebral hemorrhageMean ageMultivariate regression modelClinical dataNursing facilitiesRehabilitation facilityTherapeutic targetOlder ageMortalityStrokeNational Institute
2017
Is Risk-Standardized In-Hospital Stroke Mortality an Adequate Proxy for Risk-Standardized 30-Day Stroke Mortality Data?
Reeves M, Fonarow G, Xu H, Matsouaka R, Xian Y, Saver J, Schwamm L, Smith E. Is Risk-Standardized In-Hospital Stroke Mortality an Adequate Proxy for Risk-Standardized 30-Day Stroke Mortality Data? Circulation Cardiovascular Quality And Outcomes 2017, 10: e003748. PMID: 29021333, DOI: 10.1161/circoutcomes.117.003748.Peer-Reviewed Original ResearchMeSH KeywordsAdministrative Claims, HealthcareAgedAged, 80 and overBrain IschemiaDatabases, FactualFemaleGuideline AdherenceHospice CareHospital MortalityHospitalsHumansMaleMedicarePatient DischargePractice Guidelines as TopicQuality ImprovementQuality Indicators, Health CareRisk AssessmentRisk FactorsStrokeTime FactorsUnited StatesConceptsRisk-standardized mortality ratesHospital mortalityOutlier hospitalsAcute ischemic stroke casesHospital risk-standardized mortality ratesMortality dataGWTG-Stroke hospitalsHospital stroke mortalityIschemic stroke patientsProportion of hospitalsIschemic stroke casesRisk score modelStroke mortality dataChance-corrected agreementComposite outcomeStroke patientsMean ageStroke casesStroke mortalityMedicare filesHospital levelMortality rateLower mortalityHospitalMortalityRegional Variation in 30-Day Ischemic Stroke Outcomes for Medicare Beneficiaries Treated in Get With The Guidelines–Stroke Hospitals
Thompson M, Zhao X, Bekelis K, Gottlieb D, Fonarow G, Schulte P, Xian Y, Lytle B, Schwamm L, Smith E, Reeves M. Regional Variation in 30-Day Ischemic Stroke Outcomes for Medicare Beneficiaries Treated in Get With The Guidelines–Stroke Hospitals. Circulation Cardiovascular Quality And Outcomes 2017, 10: e003604. PMID: 28798017, DOI: 10.1161/circoutcomes.117.003604.Peer-Reviewed Original ResearchMeSH KeywordsAdministrative Claims, HealthcareAgedBrain IschemiaDatabases, FactualFee-for-Service PlansFemaleGuideline AdherenceHealth ResourcesHealthcare DisparitiesHospitalsHumansInsurance BenefitsMaleMedicarePatient ReadmissionPractice Guidelines as TopicProcess Assessment, Health CareQuality Indicators, Health CareRegistriesRisk FactorsStrokeTime FactorsTreatment OutcomeUnited StatesConceptsReadmission ratesHospital characteristicsHRR levelHealthcare resourcesGuidelines-Stroke hospitalsGuidelines-Stroke registryHealthcare resource dataIschemic stroke outcomeThirty-day mortalityIschemic stroke mortalityHospital referral region levelStroke outcomeHospital factorsPatient characteristicsStroke mortalityCare measuresMedicare beneficiariesMedicare feeMortalityDartmouth AtlasPatientsRegional variationHealth careOutcomesReadmissionAssociation Between Previous Use of Antiplatelet Therapy and Intracerebral Hemorrhage Outcomes
Khan N, Siddiqui F, Goldstein J, Cox M, Xian Y, Matsouaka R, Heidenreich P, Peterson E, Bhatt D, Fonarow G, Schwamm L, Smith E. Association Between Previous Use of Antiplatelet Therapy and Intracerebral Hemorrhage Outcomes. Stroke 2017, 48: 1810-1817. PMID: 28596454, DOI: 10.1161/strokeaha.117.016290.Peer-Reviewed Original ResearchConceptsAntiplatelet therapyIntracerebral hemorrhageHospital mortalityPrevious useDiagnosis of ICHCombination antiplatelet therapyGuidelines-Stroke hospitalsPrestroke antiplatelet therapyTerms of comorbiditiesOral anticoagulant therapyIntracerebral hemorrhage outcomesAPT groupHigh-risk profileHospital presentationAnticoagulant therapyBaseline characteristicsAntiplatelet agentsHospital characteristicsHigh riskPatientsRisk profileMortalityTherapyAPT useComorbidities
2016
Use and Outcomes of Intravenous Thrombolysis for Acute Ischemic Stroke in Patients ≥90 Years of Age
Arora R, Salamon E, Katz J, Cox M, Saver J, Bhatt D, Fonarow G, Peterson E, Smith E, Schwamm L, Xian Y, Libman R. Use and Outcomes of Intravenous Thrombolysis for Acute Ischemic Stroke in Patients ≥90 Years of Age. Stroke 2016, 47: 2347-2354. PMID: 27491734, DOI: 10.1161/strokeaha.116.012241.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, IntravenousAdolescentAdultAge FactorsAgedAged, 80 and overBrain IschemiaFemaleFibrinolytic AgentsHospital MortalityHumansIntracranial HemorrhagesMaleMiddle AgedPractice Patterns, Physicians'PrognosisRegistriesRetrospective StudiesStrokeThrombolytic TherapyTissue Plasminogen ActivatorTreatment OutcomeYoung AdultConceptsIntravenous tissue-type plasminogen activatorTissue-type plasminogen activatorAcute ischemic strokeSymptomatic hemorrhageTPA useIschemic strokeYounger patientsFunctional outcomeQuality improvement registryGood functional outcomeYears of ageYounger age groupsIntravenous thrombolysisHospital mortalityFibrinolytic therapyAcute rehabilitationIndependent ambulationDischarge outcomesMultivariable analysisHospice dischargePatientsAge groupsHemorrhagePlasminogen activatorMortality
2015
Smoking Paradox in Patients Hospitalized With Coronary Artery Disease or Acute Ischemic Stroke
Ali S, Smith E, Reeves M, Zhao X, Xian Y, Hernandez A, Bhatt D, Fonarow G, Schwamm L. Smoking Paradox in Patients Hospitalized With Coronary Artery Disease or Acute Ischemic Stroke. Circulation Cardiovascular Quality And Outcomes 2015, 8: s73-s80. PMID: 26515213, DOI: 10.1161/circoutcomes.114.001244.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeCoronary artery diseaseVascular risk factorsAdjusted odds ratioHospital mortalityRisk factorsIschemic strokeArtery diseaseOdds ratioProspective population-based studyPast-year smokersResidual unmeasured confoundingPopulation-based studyAge-stratified analysisPotent risk factorPast-year smokingConsecutive patientsMultivariable modelSmokersSmokingPatientsSignificant associationMortalitySubstantial confoundingUnmeasured confounding
2014
Hospital Case Volume Is Associated With Mortality in Patients Hospitalized With Subarachnoid Hemorrhage
Prabhakaran S, Fonarow G, Smith E, Liang L, Xian Y, Neely M, Peterson E, Schwamm L. Hospital Case Volume Is Associated With Mortality in Patients Hospitalized With Subarachnoid Hemorrhage. Neurosurgery 2014, 75: 500-508. PMID: 24979097, DOI: 10.1227/neu.0000000000000475.Peer-Reviewed Original ResearchConceptsHospital case volumeHospital mortalitySubarachnoid hemorrhageCase volumeSAH volumeSAH patientsHospital characteristicsMedian annual case volumeGuidelines-Stroke registryLarge nationwide registryMultivariable logistic regressionLength of stayAnnual case volumeContemporary national dataIndependent ambulatory statusAmbulatory statusExperienced centersNationwide registryDischarge diagnosisOptimized careImproved outcomesRelevant patientsPatientsHospitalMortalityImpact of centralising acute stroke services in English metropolitan areas on mortality and length of hospital stay: difference-in-differences analysis
Morris S, Hunter R, Ramsay A, Boaden R, McKevitt C, Perry C, Pursani N, Rudd A, Schwamm L, Turner S, Tyrrell P, Wolfe C, Fulop N. Impact of centralising acute stroke services in English metropolitan areas on mortality and length of hospital stay: difference-in-differences analysis. The BMJ 2014, 349: g4757. PMID: 25098169, PMCID: PMC4122734, DOI: 10.1136/bmj.g4757.Peer-Reviewed Original ResearchConceptsAcute stroke servicesAcute stroke careHospital stayHyperacute careStroke servicesStroke careHospital Episode Statistics databaseSymptoms of strokePatient-level dataSignificant declineIschemic strokeHospital admissionStayPatientsAbsolute reductionMortalityStrokeMortality dataCareStatistics databaseMonth periodGreater ManchesterAdmissionDaysRisk
2013
Relationship between sex, ejection fraction, and B-type natriuretic peptide levels in patients hospitalized with heart failure and associations with inhospital outcomes: Findings from the Get With The Guideline–Heart Failure Registry
Hsich E, Grau-Sepulveda M, Hernandez A, Eapen Z, Xian Y, Schwamm L, Bhatt D, Fonarow G. Relationship between sex, ejection fraction, and B-type natriuretic peptide levels in patients hospitalized with heart failure and associations with inhospital outcomes: Findings from the Get With The Guideline–Heart Failure Registry. American Heart Journal 2013, 166: 1063-1071.e3. PMID: 24268222, DOI: 10.1016/j.ahj.2013.08.029.Peer-Reviewed Original ResearchConceptsB-type natriuretic peptide levelsMedian BNP levelNatriuretic peptide levelsEjection fractionInhospital mortalityHeart failureBNP levelsHF patientsPeptide levelsPlasma B-type natriuretic peptide (BNP) levelsGuidelines-Heart Failure registryGuidelines-Heart FailurePrimary end pointInhospital outcomesBNP valuesHospital clusteringPrognostic significanceClinical variablesLarge registriesOdds ratioPatientsBNPHigh mortalityEnd pointMortalityImpact on Clinical and Cost Outcomes of a Centralized Approach to Acute Stroke Care in London: A Comparative Effectiveness Before and After Model
Hunter R, Davie C, Rudd A, Thompson A, Walker H, Thomson N, Mountford J, Schwamm L, Deanfield J, Thompson K, Dewan B, Mistry M, Quoraishi S, Morris S. Impact on Clinical and Cost Outcomes of a Centralized Approach to Acute Stroke Care in London: A Comparative Effectiveness Before and After Model. PLOS ONE 2013, 8: e70420. PMID: 23936427, PMCID: PMC3731285, DOI: 10.1371/journal.pone.0070420.Peer-Reviewed Original ResearchConceptsAcute stroke careHyper-acute stroke unitLength of stayStroke careStroke patientsReduced hospital lengthAcute stroke patientsNational time trendsDecision analytic modelHospital lengthPatient characteristicsStroke RegisterStroke unitClinical outcomesSpecialist careLocal hospitalPatientsSurvival rateComparative effectivenessCost outcomesSurvival analysisStayTotal cost savingsMortalityCareA Risk Score for In‐Hospital Death in Patients Admitted With Ischemic or Hemorrhagic Stroke
Smith E, Shobha N, Dai D, Olson D, Reeves M, Saver J, Hernandez A, Peterson E, Fonarow G, Schwamm L. A Risk Score for In‐Hospital Death in Patients Admitted With Ischemic or Hemorrhagic Stroke. Journal Of The American Heart Association 2013, 2: e005207. PMID: 23525444, PMCID: PMC3603253, DOI: 10.1161/jaha.112.005207.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBrain IschemiaCerebral HemorrhageChi-Square DistributionDecision Support TechniquesFemaleHospital MortalityHumansInpatientsLogistic ModelsMaleMiddle AgedMultivariate AnalysisPredictive Value of TestsRegistriesReproducibility of ResultsRisk AssessmentRisk FactorsSeverity of Illness IndexStrokeSubarachnoid HemorrhageUnited StatesConceptsStroke typeIschemic strokeIntracerebral hemorrhageRisk scoreGuidelines-Stroke databaseHealth Stroke ScaleIn-Hospital DeathRisk of deathHospital mortalityHospital deathStroke ScaleStroke admissionsIndependent predictorsHemorrhagic strokeStroke patientsC-statisticSingle risk scoreOverall populationLogistic regressionPatientsValidation sampleMortalityDeathPoint scorePrediction score
2012
Relationship of National Institutes of Health Stroke Scale to 30-Day Mortality in Medicare Beneficiaries With Acute Ischemic Stroke
Fonarow G, Saver J, Smith E, Broderick J, Kleindorfer D, Sacco R, Pan W, Olson D, Hernandez A, Peterson E, Schwamm L. Relationship of National Institutes of Health Stroke Scale to 30-Day Mortality in Medicare Beneficiaries With Acute Ischemic Stroke. Journal Of The American Heart Association 2012, 1: 42-50. DOI: 10.1161/xjaha.111.000034.Peer-Reviewed Original Research
2011
Comparison of Composite Measure Methodologies for Rewarding Quality of Care
Eapen Z, Fonarow G, Dai D, O'Brien S, Schwamm L, Cannon C, Heidenreich P, Bhatt D, Peterson E, Hernandez A. Comparison of Composite Measure Methodologies for Rewarding Quality of Care. Circulation Cardiovascular Quality And Outcomes 2011, 4: 610-618. PMID: 22010200, DOI: 10.1161/circoutcomes.111.961391.Peer-Reviewed Original ResearchConceptsReadmission ratesHospital rankingsRisk-standardized readmission ratesRisk-standardized mortality ratesOpportunity-based scoreAcute myocardial infarctionBottom quintileComposite scoreModest correlationQuality Improvement ProgramComposite measureCause mortalityNumber of hospitalsHealth care performanceMyocardial infarctionMortality rateHospitalCare performanceScoresSimilar changesMortalityQuintileObservational analysisComposite performance measureResponse to Letter by Khan et al Regarding Article, “Hospital-Level Variation in Mortality and Rehospitalization for Medicare Beneficiaries With Acute Ischemic Stroke”
Fonarow G, Smith E, Schwamm L. Response to Letter by Khan et al Regarding Article, “Hospital-Level Variation in Mortality and Rehospitalization for Medicare Beneficiaries With Acute Ischemic Stroke”. Stroke 2011, 42: e405. DOI: 10.1161/strokeaha.111.614909.Peer-Reviewed Original Research
2010
Hospital Certification for Optimizing Cardiovascular Disease and Stroke Quality of Care and Outcomes
Fonarow G, Gregory T, Driskill M, Stewart M, Beam C, Butler J, Jacobs A, Meltzer N, Peterson E, Schwamm L, Spertus J, Yancy C, Tomaselli G, Sacco R. Hospital Certification for Optimizing Cardiovascular Disease and Stroke Quality of Care and Outcomes. Circulation 2010, 122: 2459-2469. PMID: 21098429, DOI: 10.1161/cir.0b013e3182011a81.Peer-Reviewed Original ResearchConceptsAmerican Heart Association/American Stroke AssociationAmerican Stroke AssociationCardiovascular diseaseStroke AssociationStroke qualityEvidence-based careStroke patientsLeading causeCurrent evidenceHospital accreditationStrokeDiseaseHealthcare expendituresHospital certificationCareOutcomesPatientsFuture strategiesAssociationHealthcare organizationsHospitalMixed findingsMortality
2009
Hospital performance recognition with the Get With The Guidelines Program and mortality for acute myocardial infarction and heart failure
Heidenreich P, Lewis W, LaBresh K, Schwamm L, Fonarow G. Hospital performance recognition with the Get With The Guidelines Program and mortality for acute myocardial infarction and heart failure. American Heart Journal 2009, 158: 546-553. PMID: 19781413, DOI: 10.1016/j.ahj.2009.07.031.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionHeart failureMyocardial infarctionProcess of careAdditional adjustmentGuideline programHeart failure mortalityRisk-adjusted mortalityAmerican Heart AssociationAcute myocardial infractionMI mortalityHeart AssociationHospital characteristicsMyocardial infractionLower riskHospitalMortalityMedicaid ServicesCareHigh levelsInfarctionCardiac processesMedicareFailureGWTG