2021
Association of Hospital Telestroke Adoption With Changes in Initial Hospital Presentation and Transfers Among Patients With Stroke and Transient Ischemic Attacks
Zachrison K, Richard J, Wilcock A, Zubizaretta J, Schwamm L, Uscher-Pines L, Mehrotra A. Association of Hospital Telestroke Adoption With Changes in Initial Hospital Presentation and Transfers Among Patients With Stroke and Transient Ischemic Attacks. JAMA Network Open 2021, 4: e2126612. PMID: 34554236, PMCID: PMC8461501, DOI: 10.1001/jamanetworkopen.2021.26612.Peer-Reviewed Original ResearchConceptsHospital stroke volumeControl hospitalsStroke volumeStroke centersStroke symptomsStroke systemsCase mixTransient ischemic attack admissionsHospital pairsInitial hospital presentationThrombectomy-capable hospitalsComprehensive stroke centerTransient ischemic attackPrimary stroke centerCross-sectional studyMajor teaching hospitalObserved patient characteristicsBed sizeHospital presentationIschemic attackInitial hospitalCritical access hospitalsPatient characteristicsInterhospital transferPostimplementation period
2019
Ischaemic stroke
Campbell B, De Silva D, Macleod M, Coutts S, Schwamm L, Davis S, Donnan G. Ischaemic stroke. Nature Reviews Disease Primers 2019, 5: 70. PMID: 31601801, DOI: 10.1038/s41572-019-0118-8.Peer-Reviewed Original ResearchConceptsIschemic strokeIntravenous thrombolysisEndovascular thrombectomyStroke onsetSevere symptomatic carotid artery stenosisSymptomatic carotid artery stenosisSalvageable brain tissueBlood pressure controlCardiovascular risk managementLarge vessel occlusionMajority of strokesMechanism of strokeOnset of strokeCarotid artery stenosisCause of disabilitySecond highest causeSystems of careAntithrombotic medicationRapid reperfusionReperfusion therapySecondary preventionStroke symptomsArterial occlusionArtery stenosisCarotid endarterectomyThe Mild and Rapidly Improving Stroke Study (MaRISS): Rationale and design
Romano J, Gardener H, Campo-Bustillo I, Khan Y, Riley N, Tai S, Sacco R, Khatri P, Smith E, Schwamm L. The Mild and Rapidly Improving Stroke Study (MaRISS): Rationale and design. International Journal Of Stroke 2019, 14: 983-986. PMID: 31496438, DOI: 10.1177/1747493019873595.Peer-Reviewed Original ResearchConceptsStroke symptomsStroke Impact Scale-16Actual treatment ratesMild ischemic strokePrimary safety outcomeSymptomatic hemorrhagic transformationProportion of patientsThird of patientsProspective observational studyEffect of alteplaseAcute stroke trialsLong-term outcomesPredictors of outcomeAlteplase treatmentHemorrhagic transformationIschemic strokeRankin ScaleSecondary outcomesBarthel IndexPrimary outcomeResidual disabilityStroke presentationRetrospective studyStroke StudyStroke trials
2016
Distinct Short-Term Outcomes in Patients With Mild Versus Rapidly Improving Stroke Not Treated With Thrombolytics
Romano J, Smith E, Liang L, Gardener H, Campo-Bustillo I, Khatri P, Bhatt D, Fonarow G, Sacco R, Schwamm L. Distinct Short-Term Outcomes in Patients With Mild Versus Rapidly Improving Stroke Not Treated With Thrombolytics. Stroke 2016, 47: 1278-1285. PMID: 26987870, DOI: 10.1161/strokeaha.115.011528.Peer-Reviewed Original ResearchConceptsHealth Stroke ScaleShort-term outcomesMild strokeHome dischargeIndependent ambulationStroke ScaleHealth Stroke Scale 0National InstituteGuidelines-Stroke registryVascular risk factorsLength of stayHospital mortalityHospital deathIschemic strokeSymptom onsetDischarge outcomesStroke presentationStroke symptomsHospital covariatesAdjusted outcomesRisk factorsWorse outcomesMultivariable modelRetrospective analysisGreater severity
2015
Racial/Ethnic and Sex Differences in Emergency Medical Services Transport Among Hospitalized US Stroke Patients: Analysis of the National Get With The Guidelines–Stroke Registry
Mochari-Greenberger H, Xian Y, Hellkamp A, Schulte P, Bhatt D, Fonarow G, Saver J, Reeves M, Schwamm L, Smith E. Racial/Ethnic and Sex Differences in Emergency Medical Services Transport Among Hospitalized US Stroke Patients: Analysis of the National Get With The Guidelines–Stroke Registry. Journal Of The American Heart Association 2015, 4: e002099. PMID: 26268882, PMCID: PMC4599467, DOI: 10.1161/jaha.115.002099.Peer-Reviewed Original ResearchMeSH KeywordsAgedAsianBlack or African AmericanChi-Square DistributionEmergency Medical ServicesFemaleHealth Knowledge, Attitudes, PracticeHispanic or LatinoHospitalizationHumansLogistic ModelsMaleMiddle AgedMultivariate AnalysisOdds RatioPatient Acceptance of Health CareRegistriesSex FactorsStrokeTransportation of PatientsUnited StatesWhite PeopleConceptsEmergency medical servicesStroke patientsStroke symptomsEMS useRace/ethnicityHospitalized acute stroke patientsEmergency medical services transportWhite womenGuidelines-Stroke registryAcute stroke patientsMultivariable logistic regressionLevel of consciousnessSex differencesGuidelines-StrokeNational GetIschemic strokeStroke outcomePatient characteristicsPotential confoundersMedical historyEMS transportSex disparitiesPatientsHispanic menLogistic regression
2012
Predictors of Rapid Brain Imaging in Acute Stroke
Kelly A, Hellkamp A, Olson D, Smith E, Schwamm L. Predictors of Rapid Brain Imaging in Acute Stroke. Stroke 2012, 43: 1279-1284. PMID: 22442169, DOI: 10.1161/strokeaha.111.626374.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedDiabetes MellitusEmergency Service, HospitalFemaleFibrinolytic AgentsGuideline AdherenceHumansMagnetic Resonance ImagingMaleMultivariate AnalysisNeuroimagingPractice Guidelines as TopicRacial GroupsRetrospective StudiesSex FactorsStrokeThrombolytic TherapyTime FactorsTissue Plasminogen ActivatorTomography, X-Ray ComputedConceptsEmergency department arrivalBrain imagingSymptom onsetHealth Stroke Scale scoreFuture quality improvement initiativesGuidelines-Stroke programStroke Scale scoreStroke symptom onsetAcute stroke symptomsHistory of diabetesPeripheral vascular diseaseMultivariable logistic regressionQuality improvement initiativesEffectiveness of thrombolysisOverall imaging rateProsthetic heart valvesPredictive variablesAcute strokeMost patientsHospital clusteringIndependent predictorsStroke symptomsNonwhite raceEmergency departmentVascular disease
2005
Poor Outcomes in Patients Who Do Not Receive Intravenous Tissue Plasminogen Activator Because of Mild or Improving Ischemic Stroke
Smith E, Abdullah A, Petkovska I, Rosenthal E, Koroshetz W, Schwamm L. Poor Outcomes in Patients Who Do Not Receive Intravenous Tissue Plasminogen Activator Because of Mild or Improving Ischemic Stroke. Stroke 2005, 36: 2497-2499. PMID: 16210552, DOI: 10.1161/01.str.0000185798.78817.f3.Peer-Reviewed Original ResearchConceptsIntravenous tissue plasminogen activatorTissue plasminogen activatorNeurological worseningPoor outcomeHealth Stroke Scale scoreProspective single-center studyPlasminogen activatorStroke Scale scoreSingle-center studyIschemic stroke symptomsTPA eligibilityHome dischargeIschemic strokeNeurological deficitsSymptom onsetStroke symptomsSeverity criteriaPatientsScale scoreNational InstituteSubstantial minoritySymptomsStrokeWorseningOutcomes
2002
Predicting cerebral ischemic infarct volume with diffusion and perfusion MR imaging.
Schaefer P, Hunter G, He J, Hamberg L, Sorensen A, Schwamm L, Koroshetz W, Gonzalez R. Predicting cerebral ischemic infarct volume with diffusion and perfusion MR imaging. American Journal Of Neuroradiology 2002, 23: 1785-94. PMID: 12427640, PMCID: PMC8185825.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overBlood Flow VelocityBrain IschemiaCerebral InfarctionCerebrovascular CirculationDiffusion Magnetic Resonance ImagingFalse Positive ReactionsFemaleFollow-Up StudiesHumansIschemic Attack, TransientMagnetic Resonance AngiographyMaleMiddle AgedObserver VariationPredictive Value of TestsSensitivity and SpecificityTime FactorsConceptsCerebral blood flowCerebral blood volumeFinal infarct volumeInfarct volumeDW imagingLesion growthAcute ischemic stroke symptomsHemodynamic imagesAcute ischemic infarctionIschemic infarct volumeInitial clinical assessmentFinal discharge diagnosisFinal infarct sizeHours of onsetIschemic stroke symptomsPerfusion MR imagingPerfusion-weighted imagesAcute strokeIschemic infarctionStroke symptomsAcute infarctionAcute lesionsDischarge diagnosisInfarct sizeAltered perfusion
1999
Diffusion-weighted MR Imaging: Diagnostic Accuracy in Patients Imaged within 6 Hours of Stroke Symptom Onset
González R, Schaefer P, Buonanno F, Schwamm L, Budzik R, Rordorf G, Wang B, Sorensen A, Koroshetz W. Diffusion-weighted MR Imaging: Diagnostic Accuracy in Patients Imaged within 6 Hours of Stroke Symptom Onset. Radiology 1999, 210: 155-62. PMID: 9885601, DOI: 10.1148/radiology.210.1.r99ja02155.Peer-Reviewed Original ResearchConceptsFinal clinical diagnosisDiffusion-weighted imagesDiffusion-weighted MR imagingDiffusion-weighted imagingConventional MR imagingMR imagingSymptom onsetBlinded reviewClinical diagnosisDiagnostic accuracyStroke symptom onsetDiffusion-weighted magnetic resonance imagingMagnetic resonance imagingT2-weighted MR imagingAcute strokeStroke symptomsFinal diagnosisTomographic scanStrokelike symptomsPatientsPatient recordsResonance imagingStrokeDiagnosisCT