2023
Effectiveness of a Quality Improvement Intervention on Reperfusion Treatment for Patients With Acute Ischemic Stroke
Wang C, Gu H, Zong L, Zhang X, Zhou Q, Jiang Y, Li H, Meng X, Yang X, Wang M, Huo X, Wangqin R, Bei Y, Qi X, Liu X, Hu S, Wang Z, Zhao X, Wang Y, Liu L, Ma X, Morgan L, Xian Y, Schwamm L, Wang Y, Li Z, Yang Q, Chen G, Ma Q, Li X, Chen J, Zhao X, Wang H, Niu X, Xu J, Zhao L, Wang Z, Huang D, Jin X, Chen S, Li J, Yu J, Liu P, Li G, Hao Y, Yang G, Huang X, Zhou C, Yang J, Gu J, Sun P, Guo Z, Ma G, Chen G, Tang M, Wang N, Chen L, Li J, Li A, Li S, Cao M, Guo J, Ren Y, Li T, Zhang L, Xie Z, Dong J, Kong X, Liang H, Zhang Y. Effectiveness of a Quality Improvement Intervention on Reperfusion Treatment for Patients With Acute Ischemic Stroke. JAMA Network Open 2023, 6: e2316465. PMID: 37266940, PMCID: PMC10238948, DOI: 10.1001/jamanetworkopen.2023.16465.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeQuality improvement interventionsTargeted quality improvement interventionsReperfusion therapy ratesProportion of patientsIschemic strokeEligible patientsStepped-wedge clusterSymptom onsetReperfusion therapyEndovascular thrombectomyImprovement interventionsTherapy ratesUsual careSecondary outcomesPrimary outcomeSecondary hospitalsClinical trialsIntravenous recombinant tissue plasminogen activatorModified Rankin Scale scoreRecombinant tissue plasminogen activatorRankin Scale scoreTissue plasminogen activatorEVT rateHospital mortality
2021
Clinical Characteristics, Management, and In-Hospital Outcomes in Patients With Stroke or Transient Ischemic Attack in China
Gu H, Yang X, Wang C, Zhao X, Wang Y, Liu L, Meng X, Jiang Y, Li H, Liu C, Wangqin R, Fonarow G, Schwamm L, Xian Y, Li Z, Wang Y. Clinical Characteristics, Management, and In-Hospital Outcomes in Patients With Stroke or Transient Ischemic Attack in China. JAMA Network Open 2021, 4: e2120745. PMID: 34387677, PMCID: PMC8363916, DOI: 10.1001/jamanetworkopen.2021.20745.Peer-Reviewed Original ResearchConceptsTransient ischemic attackChinese Stroke Center AllianceMajor adverse cardiovascular eventsHospital clinical outcomesQuality improvement studyIschemic strokeIntracerebral hemorrhageIschemic attackClinical characteristicsClinical outcomesPoor outcomeIntravenous recombinant tissue plasminogen activatorTemporal improvementRecombinant tissue plasminogen activatorAdverse cardiovascular eventsIn-Hospital OutcomesUse of anticoagulantsComposite scoreImprovement studyTissue plasminogen activatorMean composite scoreHealth care systemHospital complicationsTIA admissionsTIA care
2019
Thrombolytic therapy in older acute ischemic stroke patients with gastrointestinal malignancy or recent bleeding
Inohara T, Liang L, Kosinski A, Smith E, Schwamm L, Hernandez A, Bhatt D, Fonarow G, Peterson E, Xian Y. Thrombolytic therapy in older acute ischemic stroke patients with gastrointestinal malignancy or recent bleeding. European Stroke Journal 2019, 5: 47-55. PMID: 32232169, PMCID: PMC7092738, DOI: 10.1177/2396987319871784.Peer-Reviewed Original ResearchRecombinant tissue plasminogen activatorRecent gastrointestinal bleedingAcute ischemic strokeGastrointestinal malignanciesIschemic strokeGastrointestinal bleedingHospital mortalityIntravenous recombinant tissue plasminogen activatorOlder acute ischemic stroke patientsAcute ischemic stroke patientsRtPA-treated patientsIschemic stroke patientsTissue plasminogen activatorOutcomes of interestGuidelines-StrokeIndex strokeRecent bleedingSevere strokeObservational cohortClinical outcomesStroke patientsThrombolytic therapyBleedingSystemic hemorrhagePatients
2017
Use of Intravenous Recombinant Tissue Plasminogen Activator in Patients With Acute Ischemic Stroke Who Take Non–Vitamin K Antagonist Oral Anticoagulants Before Stroke
Xian Y, Federspiel J, Hernandez A, Laskowitz D, Schwamm L, Bhatt D, Smith E, Fonarow G, Peterson E. Use of Intravenous Recombinant Tissue Plasminogen Activator in Patients With Acute Ischemic Stroke Who Take Non–Vitamin K Antagonist Oral Anticoagulants Before Stroke. Circulation 2017, 135: 1024-1035. PMID: 28119380, DOI: 10.1161/circulationaha.116.023940.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, IntravenousAgedAged, 80 and overAnticoagulantsDabigatranFemaleFibrinolytic AgentsHemorrhageHospital MortalityHumansInternational Normalized RatioMalePyrazolesPyridonesRecombinant ProteinsRegistriesRetrospective StudiesRisk FactorsRivaroxabanStrokeTime FactorsTissue Plasminogen ActivatorTreatment OutcomeWarfarinConceptsIntravenous rt-PASymptomatic intracranial hemorrhageIschemic strokeRt-PAIntracranial hemorrhageOdds ratioNon-Vitamin K Antagonist Oral AnticoagulantsIntravenous recombinant tissue plasminogen activatorK Antagonist Oral AnticoagulantsRecombinant tissue plasminogen activatorGuidelines-Stroke registrySerious systemic hemorrhageAcute ischemic strokeAdjusted odds ratioAmerican Heart AssociationTissue plasminogen activatorOutcomes of useHospital mortalityRegistry hospitalsOral anticoagulantsSevere strokeAdverse eventsProhibitive riskRankin ScaleThrombolytic therapy
2015
Treatment and Outcome of Thrombolysis-Related Hemorrhage: A Multicenter Retrospective Study
Yaghi S, Boehme A, Dibu J, Guerrero C, Ali S, Martin-Schild S, Sands K, Noorian A, Blum C, Chaudhary S, Schwamm L, Liebeskind D, Marshall R, Willey J. Treatment and Outcome of Thrombolysis-Related Hemorrhage: A Multicenter Retrospective Study. JAMA Neurology 2015, 72: 1-7. PMID: 26501741, PMCID: PMC4845894, DOI: 10.1001/jamaneurol.2015.2371.Peer-Reviewed Original ResearchConceptsSymptomatic intracerebral hemorrhageRecombinant tissue plasminogen activatorMulticenter retrospective studyHematoma expansionHospital mortalityMedian timeRetrospective studyIntravenous recombinant tissue plasminogen activatorHealth Stroke Scale scoreParenchymal hematoma type 2Code status changeOutcome of thrombolysisStroke-Monitoring StudyComprehensive stroke centerHospital mortality rateOutcomes of patientsStroke Scale scoreTissue plasminogen activatorIschemic strokePrimary outcomeRtPA therapySecondary outcomesStroke centersSymptom onsetIntracerebral hemorrhageOutcomes in Mild Acute Ischemic Stroke Treated With Intravenous Thrombolysis: A Retrospective Analysis of the Get With the Guidelines–Stroke Registry
Romano J, Smith E, Liang L, Gardener H, Camp S, Shuey L, Cook A, Campo-Bustillo I, Khatri P, Bhatt D, Fonarow G, Sacco R, Schwamm L. Outcomes in Mild Acute Ischemic Stroke Treated With Intravenous Thrombolysis: A Retrospective Analysis of the Get With the Guidelines–Stroke Registry. JAMA Neurology 2015, 72: 423-431. PMID: 25642650, DOI: 10.1001/jamaneurol.2014.4354.Peer-Reviewed Original ResearchConceptsRecombinant tissue plasminogen activatorHealth Stroke Scale scoreStroke Scale scoreSymptomatic intracranial hemorrhageShort-term outcomesIntravenous recombinant tissue plasminogen activatorGuidelines-Stroke registrySerious systemic hemorrhageAcute ischemic strokeLength of stayMild strokeTreatment complicationsIschemic strokeIntracranial hemorrhageScale scoreSymptom onsetSerious complicationsRetrospective analysisSystemic hemorrhageMild acute ischemic strokeNational InstituteWorse short-term outcomesBaseline National InstitutesHigher National InstitutesQuality improvement registry
2012
Safety of full-dose intravenous recombinant tissue plasminogen activator followed by multimodal endovascular therapy for acute ischemic stroke
Nogueira R, Yoo A, Masrur S, Batista L, Hakimelahi R, Hirsch J, Schwamm L. Safety of full-dose intravenous recombinant tissue plasminogen activator followed by multimodal endovascular therapy for acute ischemic stroke. Journal Of NeuroInterventional Surgery 2012, 5: 298. PMID: 22705875, DOI: 10.1136/neurintsurg-2012-010376.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overBrain IschemiaCombined Modality TherapyEndovascular ProceduresFemaleHumansInjections, IntravenousMaleMiddle AgedProspective StudiesRecombinant ProteinsRetrospective StudiesStrokeThrombolytic TherapyTissue Plasminogen ActivatorTreatment OutcomeYoung AdultConceptsMultimodal endovascular therapySymptomatic intracranial hemorrhageIntravenous recombinant tissue plasminogen activatorRecombinant tissue plasminogen activatorEndovascular therapyTissue plasminogen activatorParenchymal hematomaSafety endpointHospital dischargeFunctional outcomeFull-dose intravenous recombinant tissue plasminogen activatorPlasminogen activatorIndependent functional outcomeIntravenous rt-PAPrimary safety endpointRt-PA dosageSecondary safety endpointSevere systemic bleedingSimilar safety profileAcute ischemic strokeRate of recanalizationClinical efficacy endpointsT-PA doseBridging therapyGroin hematoma
2010
Quality of Care and Outcomes in Patients With Diabetes Hospitalized With Ischemic Stroke
Reeves M, Vaidya R, Fonarow G, Liang L, Smith E, Matulonis R, Olson D, Schwamm L. Quality of Care and Outcomes in Patients With Diabetes Hospitalized With Ischemic Stroke. Stroke 2010, 41: e409-e417. PMID: 20224058, DOI: 10.1161/strokeaha.109.572693.Peer-Reviewed Original ResearchConceptsQuality of careStroke-related outcomesIschemic stroke patientsStroke patientsRt-PACholesterol treatmentIntravenous recombinant tissue plasminogen activatorRecombinant tissue plasminogen activatorCommon comorbid diseasesGuidelines-Stroke programPercent of patientsSecondary prevention treatmentHours of onsetMultivariable logistic regressionTissue plasminogen activatorUnited States hospitalsQuality improvement effortsGWTG-StrokeHospital mortalityDischarge homeHospital deathHospital outcomesStroke recurrenceComorbid diseasesIschemic stroke
2009
Endovascular Approaches to Acute Stroke, Part 1: Drugs, Devices, and Data
Nogueira R, Schwamm L, Hirsch J. Endovascular Approaches to Acute Stroke, Part 1: Drugs, Devices, and Data. American Journal Of Neuroradiology 2009, 30: 649-661. PMID: 19279271, PMCID: PMC7051752, DOI: 10.3174/ajnr.a1486.Peer-Reviewed Original ResearchConceptsRecombinant tissue plasminogen activatorIntravenous recombinant tissue plasminogen activatorLonger treatment windowsAcute stroke treatmentHigher recanalization ratesTissue plasminogen activatorPublic health concernMechanical revascularizationAcute strokeReperfusion techniquesEndovascular therapyStroke treatmentEndovascular approachRecanalization ratePharmacologic strategiesTreatment windowUS FoodDrug AdministrationWire disruptionTheoretic advantagesPreclinical trialsHealth concernPlasminogen activatorTherapyStroke
2006
The Paul Coverdell National Acute Stroke Registry Initial Results from Four Prototypes
Reeves M, Broderick J, Frankel M, LaBresh K, Schwamm L, Moomaw C, Weiss P, Katzan I, Arora S, Heinrich J, Hickenbottom S, Karp H, Malarcher A, Mensah G, Reeves M. The Paul Coverdell National Acute Stroke Registry Initial Results from Four Prototypes. American Journal Of Preventive Medicine 2006, 31: s202-s209. PMID: 17178304, DOI: 10.1016/j.amepre.2006.08.007.Peer-Reviewed Original ResearchConceptsRecombinant tissue plasminogen activatorTissue plasminogen activatorStroke admissionsPaul Coverdell National Acute Stroke RegistryNational Acute Stroke RegistryPlasminogen activatorAcute stroke admissionsAcute Stroke RegistrySmoking cessation counselingPercent of patientsTransient ischemic attackAcute stroke careAcute stroke patientsPercent of admissionsHours of onsetIschemic stroke admissionsHealthcare system levelQuality improvement interventionsYears of ageAntithrombotic treatmentIschemic attackLipid testingStroke RegistryEligible subjectsIschemic stroke
2005
Acute Stroke Care in the US
Reeves M, Arora S, Broderick J, Frankel M, Heinrich J, Hickenbottom S, Karp H, LaBresh K, Malarcher A, Mensah G, Moomaw C, Schwamm L, Weiss P. Acute Stroke Care in the US. Stroke 2005, 36: 1232-1240. PMID: 15890989, DOI: 10.1161/01.str.0000165902.18021.5b.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overBrain IschemiaCerebral HemorrhageFemaleFibrinolytic AgentsGeorgiaHospital RecordsHumansInfusions, IntravenousIschemic Attack, TransientMaleMassachusettsMichiganMiddle AgedOhioPilot ProjectsProspective StudiesQuality ControlRecombinant ProteinsRegistriesRetrospective StudiesStrokeThrombolytic TherapyTime FactorsTissue Plasminogen ActivatorTreatment OutcomeUnited StatesConceptsRecombinant tissue plasminogen activatorAcute stroke careStroke careStroke admissionsPaul Coverdell National Acute Stroke RegistryIntravenous recombinant tissue plasminogen activatorNational Acute Stroke RegistryHealth care system levelsAcute stroke admissionsAcute Stroke RegistryTransient ischemic attackAcute stroke patientsHours of onsetIschemic stroke admissionsMinutes of arrivalSecondary prevention practicesAge 60 yearsQuality improvement interventionsTissue plasminogen activatorIschemic attackCessation counselingStroke RegistryIschemic strokeIntracerebral hemorrhageStroke patients