2024
Twenty Years of Sustained Improvement in Quality of Care and Outcomes for Patients Hospitalized With Stroke or Transient Ischemic Attack: Data From The Get With The Guidelines-Stroke Program
Xian Y, Li S, Jiang T, Beon C, Poudel R, Thomas K, Reeves M, Smith E, Saver J, Sheth K, Messé S, Schwamm L, Fonarow G. Twenty Years of Sustained Improvement in Quality of Care and Outcomes for Patients Hospitalized With Stroke or Transient Ischemic Attack: Data From The Get With The Guidelines-Stroke Program. Stroke 2024, 55: 2599-2610. PMID: 39429153, PMCID: PMC11518659, DOI: 10.1161/strokeaha.124.048174.Peer-Reviewed Original ResearchConceptsGuidelines-Stroke programEvidence-based stroke careDoor-to-needle timeTransient ischemic attackGuidelines-Stroke hospitalsEvidence-based careQuality of careSmoking cessation counselingSustained improvementQuality improvement initiativesSkilled nursing facilityIndependence of patientsAcute ischemic strokeIschemic strokeRelevant to patientsIschemic attackDoor-to-puncture timeCessation counselingGuidelines-StrokeAssociated with sustained improvementStroke careDysphagia screeningNursing facilitiesHospital characteristicsImprovement initiativesCOVID‐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 dataPatients
2021
Associations of Medicaid Expansion With Access to Care, Severity, and Outcomes for Acute Ischemic Stroke
McGee B, Seagraves K, Smith E, Xian Y, Zhang S, Alhanti B, Matsouaka R, Reeves M, Schwamm L, Fonarow G. Associations of Medicaid Expansion With Access to Care, Severity, and Outcomes for Acute Ischemic Stroke. Circulation Cardiovascular Quality And Outcomes 2021, 14: e007940. PMID: 34587752, DOI: 10.1161/circoutcomes.121.007940.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeLow-income cohortSkilled nursing facilitiesIschemic strokeMedicaid expansionStroke admissionsNonexpansion statesNursing facilitiesLow-income US populationHigh stroke burdenPrimary stroke preventionOdds of dischargeIschemic stroke admissionsExpansion statesSeverity of presentationLevel of disabilityReceipt of rehabilitationHealth insurance statusHealth insurance coverageHospital mortalityUninsured hospitalizationsStroke preventionDischarge dispositionStroke burdenStroke outcome
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
Unexplained Variation for Hospitals’ Use of Inpatient Rehabilitation and Skilled Nursing Facilities After an Acute Ischemic Stroke
Xian Y, Thomas L, Liang L, Federspiel J, Webb L, Bushnell C, Duncan P, Schwamm L, Stein J, Fonarow G, Hoenig H, Montalvo C, George M, Lutz B, Peterson E, Bettger J. Unexplained Variation for Hospitals’ Use of Inpatient Rehabilitation and Skilled Nursing Facilities After an Acute Ischemic Stroke. Stroke 2017, 48: 2836-2842. PMID: 28830975, DOI: 10.1161/strokeaha.117.016904.Peer-Reviewed Original ResearchConceptsInpatient rehabilitation facilitySkilled nursing facilitiesAcute ischemic strokeHospital-level variationIschemic strokeNursing facilitiesGuidelines-Stroke hospitalsMultilevel logistic regression modelsMedian odds ratioGeographic availabilityLogistic regression modelsIRF patientsHospital complicationsSNF patientsClinical characteristicsComorbid conditionsInpatient rehabilitationHospital characteristicsClinical registryOdds ratioRehabilitation facilityHospital useMedicare beneficiariesPatientsHospital
2016
Impact of Insurance Status on Outcomes and Use of Rehabilitation Services in Acute Ischemic Stroke: Findings From Get With The Guidelines‐Stroke
Medford‐Davis L, Fonarow G, Bhatt D, Xu H, Smith E, Suter R, Peterson E, Xian Y, Matsouaka R, Schwamm L. Impact of Insurance Status on Outcomes and Use of Rehabilitation Services in Acute Ischemic Stroke: Findings From Get With The Guidelines‐Stroke. Journal Of The American Heart Association 2016, 5: e004282. PMID: 27930356, PMCID: PMC5210352, DOI: 10.1161/jaha.116.004282.Peer-Reviewed Original ResearchMeSH KeywordsAgedAmbulancesAnticholesteremic AgentsAntihypertensive AgentsBrain IschemiaDiabetes MellitusFemaleGuideline AdherenceHospital MortalityHumansHypercholesterolemiaHypertensionHypoglycemic AgentsInsurance CoverageInsurance, HealthLogistic ModelsMaleMedicaidMedically UninsuredMedicareMiddle AgedMultivariate AnalysisOdds RatioPractice Guidelines as TopicSkilled Nursing FacilitiesStrokeStroke RehabilitationTime FactorsUnited StatesConceptsAcute ischemic strokeIschemic strokeInsurance statusHospital mortalityGuidelines-Stroke programIschemic stroke patientsMultivariable logistic regressionPatient insurance statusGovernment-sponsored insuranceSkilled nursing facilitiesGuidelines-StrokeInpatient rehabPostdischarge destinationHospital outcomesPatient demographicsSymptom onsetAcute treatmentControl medicationDiabetes mellitusStroke patientsHospital characteristicsUninsured patientsHigh cholesterolNursing facilitiesPreventative careAssessment of Home-Time After Acute Ischemic Stroke in Medicare Beneficiaries
Fonarow G, Liang L, Thomas L, Xian Y, Saver J, Smith E, Schwamm L, Peterson E, Hernandez A, Duncan P, O'Brien E, Bushnell C, Prvu Bettger J. Assessment of Home-Time After Acute Ischemic Stroke in Medicare Beneficiaries. Stroke 2016, 47: 836-842. PMID: 26892279, DOI: 10.1161/strokeaha.115.011599.Peer-Reviewed Original ResearchConceptsModified Rankin ScaleIschemic strokeMedicare beneficiariesIschemic stroke Longitudinal (AVAIL) registryMedian Modified Rankin ScaleAcute ischemic strokePatient-centered outcomesSkilled nursing facilitiesGuidelines-StrokeMRS 0Older patientsRankin ScaleStroke careInpatient rehabilitationStroke survivorsC-indexOutcome measuresNursing facilitiesFunctional independenceAdherence evaluationStrokePatientsSimilar findingsMeaningful outcomesPearson correlation coefficient
2015
Contemporary Trends and Predictors of Postacute Service Use and Routine Discharge Home After Stroke
Bettger J, McCoy L, Smith E, Fonarow G, Schwamm L, Peterson E. Contemporary Trends and Predictors of Postacute Service Use and Routine Discharge Home After Stroke. Journal Of The American Heart Association 2015, 4: e001038. PMID: 25713291, PMCID: PMC4345857, DOI: 10.1161/jaha.114.001038.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overBrain IschemiaFemaleHome Health NursingHospitalizationHumansIntracranial HemorrhagesLength of StayMaleMiddle AgedMultivariate AnalysisPatient DischargeRecovery of FunctionRehabilitation CentersRisk FactorsSelf CareSkilled Nursing FacilitiesStrokeStroke RehabilitationTreatment OutcomeWalkingConceptsInpatient rehabilitation facilityPAC useSkilled nursing facilitiesHome healthStroke patientsService useHealth insurance typeHospital discharge dispositionStrongest clinical predictorsYears of agePostacute care servicesGuidelines-StrokeDischarge homeHospital stayDischarge dispositionClinical predictorsHemorrhagic strokeOral intakeDysphagia screenMultivariable analysisAcute careStroke hospitalizationsInsurance typeSNF useNursing facilities