2022
Ischemic Stroke Systems of Care in California: Evolution in the Organization During the Mechanical Thrombectomy Era
Zachrison K, Hsia R, Li S, Reeves M, Camargo C, Yan Z, Onnela J, Schwamm L. Ischemic Stroke Systems of Care in California: Evolution in the Organization During the Mechanical Thrombectomy Era. Stroke Vascular And Interventional Neurology 2022, 2 DOI: 10.1161/svin.121.000206.Peer-Reviewed Original ResearchEndovascular thrombectomyStroke systemsHospital-level factorsOdds of transferLogistic regression modelsAlteplase useEVT proceduresStroke NetworkObservational studyTimely careRural hospitalsTrial dataHospitalPatientsHospital postsHospital pairsCarePatient transfer networksRegression modelsNumber of encountersLinear regressionThrombectomyAlteplaseRegressionGreater POST
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 periodRecommendations for Regional Stroke Destination Plans in Rural, Suburban, and Urban Communities From the Prehospital Stroke System of Care Consensus Conference: A Consensus Statement From the American Academy of Neurology, American Heart Association/American Stroke Association, American Society of Neuroradiology, National Association of EMS Physicians, National Association of State EMS Officials, Society of NeuroInterventional Surgery, and Society of Vascular and Interventional Neurology: Endorsed by the Neurocritical Care Society
Jauch E, Schwamm L, Panagos P, Barbazzeni J, Dickson R, Dunne R, Foley J, Fraser J, Lassers G, Martin-Gill C, O’Brien S, Pinchalk M, Prabhakaran S, Richards C, Taillac P, Tsai A, Yallapragada A, Conference O. Recommendations for Regional Stroke Destination Plans in Rural, Suburban, and Urban Communities From the Prehospital Stroke System of Care Consensus Conference: A Consensus Statement From the American Academy of Neurology, American Heart Association/American Stroke Association, American Society of Neuroradiology, National Association of EMS Physicians, National Association of State EMS Officials, Society of NeuroInterventional Surgery, and Society of Vascular and Interventional Neurology: Endorsed by the Neurocritical Care Society. Stroke 2021, 52: e133-e152. PMID: 33691507, DOI: 10.1161/strokeaha.120.033228.Peer-Reviewed Original ResearchConceptsAmerican Heart Association/American Stroke AssociationSociety of VascularAmerican Stroke AssociationNeurocritical Care SocietyState EMS OfficialsInterventional NeurologyStroke AssociationStroke systemsConsensus statementConsensus conferenceNeurointerventional surgeryAmerican AcademyEMS physiciansAmerican SocietyNeurologyAssociationNational AssociationUrban communitiesSurgeryVascular
2020
Prehospital Stroke Care and Regionalized Stroke Systems
Zachrison K, Schwamm L. Prehospital Stroke Care and Regionalized Stroke Systems. 2020, 35-58. DOI: 10.1017/9781316286234.004.Peer-Reviewed Original ResearchPrehospital stroke careStroke careStroke systemsAcute stroke treatmentPrevention of strokeEndovascular reperfusion therapyCause of disabilityMagnetic brain stimulationCause of deathReperfusion therapyStroke preventionStroke treatmentSurgical treatmentStroke patientsStroke recoveryBrain stimulationReview GroupAppropriate interventionsOptimal evidenceTherapeutic topicsStrokeCliniciansTreatmentCarePreventionTrends Among Rural and Urban Medicare Beneficiaries in Care Delivery and Outcomes for Acute Stroke and Transient Ischemic Attacks, 2008-2017
Wilcock A, Zachrison K, Schwamm L, Uscher-Pines L, Zubizarreta J, Mehrotra A. Trends Among Rural and Urban Medicare Beneficiaries in Care Delivery and Outcomes for Acute Stroke and Transient Ischemic Attacks, 2008-2017. JAMA Neurology 2020, 77: 863-871. PMID: 32364573, PMCID: PMC7358912, DOI: 10.1001/jamaneurol.2020.0770.Peer-Reviewed Original ResearchConceptsTransient ischemic attackAcute ischemic strokeIschemic attackAcute strokeStroke centersRural-urban disparitiesResidential zip codeIschemic strokeEnd-stage kidney diseaseRural-Urban Commuting Area codesDescriptive observational studyHealth care centersUrban Medicare beneficiariesQuality of careTraditional MedicareNeurologist evaluationOutcome patientsUrban patientsStroke careNeurology consultationKidney diseaseMean ageCare centerStroke systemsObservational studyAcute ischemic stroke: improving access to intravenous tissue plasminogen activator
Turner A, Schwamm L, Etherton M. Acute ischemic stroke: improving access to intravenous tissue plasminogen activator. Expert Review Of Cardiovascular Therapy 2020, 18: 277-287. PMID: 32323590, DOI: 10.1080/14779072.2020.1759422.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeIschemic stroke patientsIschemic strokeStroke patientsTreatment windowAcute ischemic stroke patientsIntravenous tissue plasminogen activatorTreatment ratesUnknown symptom onsetAcute stroke careTissue plasminogen activatorQuality improvement initiativesHealth care resourcesUnited States FoodStroke outcomeSymptom onsetStroke careStroke specialistsStroke systemsTelestroke networkDrug AdministrationAlteplasePatientsPlasminogen activatorStates FoodCerebral Small Vessel Diseases and Sleep Related Strokes
Lauer A, Ay H, Bianchi M, Charidimou A, Boulouis G, Ayres A, Vashkevich A, Schwab K, Singhal A, Viswanathan A, Rost N, Goldstein J, Rosand J, Schwamm L, Greenberg S, Gurol M. Cerebral Small Vessel Diseases and Sleep Related Strokes. Journal Of Stroke And Cerebrovascular Diseases 2020, 29: 104606. PMID: 31937490, DOI: 10.1016/j.jstrokecerebrovasdis.2019.104606.Peer-Reviewed Original ResearchConceptsSmall vessel diseaseCerebral small vessel diseaseSmall artery occlusionIntracerebral hemorrhageIschemic strokeHemorrhagic strokeICH patientsVessel diseasePresence of SVDCerebral amyloid angiopathyLobar intracerebral hemorrhageICH cohortArtery occlusionSymptom onsetAmyloid angiopathyHemodynamic changesIS cohortRisk factorsStroke systemsCausative ClassificationStrokePatientsCohortDeep locationDisease
2019
Recommendations for the Establishment of Stroke Systems of Care: A 2019 Update: A Policy Statement From the American Stroke Association
Adeoye O, Nyström K, Yavagal D, Luciano J, Nogueira R, Zorowitz R, Khalessi A, Bushnell C, Barsan W, Panagos P, Alberts M, Tiner A, Schwamm L, Jauch E. Recommendations for the Establishment of Stroke Systems of Care: A 2019 Update: A Policy Statement From the American Stroke Association. Stroke 2019, 50: e187-e210. PMID: 31104615, DOI: 10.1161/str.0000000000000173.Peer-Reviewed Original ResearchConceptsAmerican Stroke AssociationStroke systemsStroke AssociationStroke center certificationMobile stroke unitEmergency medical servicesHospital dischargeSecondary preventionStroke centersEndovascular therapyStroke unitPrimary preventionCenter certificationNeurocritical careAssociation recommendationsCareBasis of improvementStroke recognitionMedical servicesHealthcare agenciesScientific evidenceHealthcare policyAppropriate facilitiesPreventionSignificant changesUse, Temporal Trends, and Outcomes of Endovascular Therapy After Interhospital Transfer in the United States
Shah S, Xian Y, Sheng S, Zachrison KS, Saver JL, Sheth KN, Fonarow GC, Schwamm LH, Smith EE. Use, Temporal Trends, and Outcomes of Endovascular Therapy After Interhospital Transfer in the United States. Circulation 2019, 139: 1568-1577. PMID: 30700144, PMCID: PMC6816244, DOI: 10.1161/circulationaha.118.036509.Peer-Reviewed Original ResearchConceptsEndovascular therapyInterhospital transferHospital outcomesIschemic strokeMultivariable logistic regression modelSymptomatic intracranial hemorrhageAcute ischemic strokeComprehensive stroke centerLarge vessel occlusionRisk-adjusted modelsLogistic regression modelsEVT outcomesGuidelines-StrokeHospital mortalityStroke centersIndependent ambulationPivotal trialsStroke careIntracranial hemorrhageVessel occlusionEVT casesStroke systemsWhite racePatientsFurther evaluationDigital Health Strategies to Improve Care and Continuity Within Stroke Systems of Care in the United States
Schwamm L. Digital Health Strategies to Improve Care and Continuity Within Stroke Systems of Care in the United States. Circulation 2019, 139: 149-151. PMID: 30615498, DOI: 10.1161/circulationaha.117.029234.Peer-Reviewed Original Research
2018
Ischemic Stroke Transfer Patterns in the Northeast United States
Zachrison K, Onnela J, Hernandez A, Reeves M, Camargo C, Cox M, Matsouaka R, Metlay J, Goldstein J, Schwamm L. Ischemic Stroke Transfer Patterns in the Northeast United States. Journal Of Stroke And Cerebrovascular Diseases 2018, 28: 295-304. PMID: 30389376, DOI: 10.1016/j.jstrokecerebrovasdis.2018.09.048.Peer-Reviewed Original ResearchConceptsGuidelines-Stroke registryRegional stroke systemIschemic stroke patientsHospital connectionsTissue plasminogen activatorSevere strokeMore patientsStroke patientsIS patientsReceiving HospitalPatient dischargeStroke systemsPatient transferPatientsHospitalNortheast hospitalsMost hospitalsPlasminogen activatorCareUnited StatesFurther characterizationAdmissionRegistryStroke
2017
Increase in Endovascular Therapy in Get With The Guidelines-Stroke After the Publication of Pivotal Trials
Smith E, Saver J, Cox M, Liang L, Matsouaka R, Xian Y, Bhatt D, Fonarow G, Schwamm L. Increase in Endovascular Therapy in Get With The Guidelines-Stroke After the Publication of Pivotal Trials. Circulation 2017, 136: 2303-2310. PMID: 28982689, DOI: 10.1161/circulationaha.117.031097.Peer-Reviewed Original ResearchConceptsEndovascular thrombectomyEVT useEligible patientsIschemic strokePivotal trialsCase volumeStroke systemsHealth Stroke Scale scoreGuidelines-Stroke programStroke Scale scoreMean case volumeGuidelines-StrokeEndovascular therapyMore patientsPatient eligibilityPatientsClinical practiceScale scoreHospitalStrokeTrialsNational InstituteStroke durationLinear regressionThrombectomy
2016
Treatment With Tissue Plasminogen Activator in the Golden Hour and the Shape of the 4.5-Hour Time-Benefit Curve in the National United States Get With The Guidelines-Stroke Population
Kim J, Fonarow G, Smith E, Reeves M, Navalkele D, Grotta J, Grau-Sepulveda M, Hernandez A, Peterson E, Schwamm L, Saver J. Treatment With Tissue Plasminogen Activator in the Golden Hour and the Shape of the 4.5-Hour Time-Benefit Curve in the National United States Get With The Guidelines-Stroke Population. Circulation 2016, 135: 128-139. PMID: 27815374, DOI: 10.1161/circulationaha.116.023336.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeTissue plasminogen activatorIschemic strokeHospital mortalityIndependent ambulationPlasminogen activatorTissue plasminogen activator-treated patientsIntravenous tissue plasminogen activatorTissue plasminogen activator treatmentIschemic stroke outcomeHours of onsetOdds of dischargePlasminogen activator treatmentMinutes of onsetNational United StatesHemorrhagic complicationsStroke outcomeMedian onsetThrombolytic therapyStroke systemsBetter outcomesPatientsActivator treatmentGolden hourTreatment time
2015
Endovascular Clot Retrieval Therapy
Smith E, Schwamm L. Endovascular Clot Retrieval Therapy. Stroke 2015, 46: 1462-1467. PMID: 25944330, DOI: 10.1161/strokeaha.115.008385.Peer-Reviewed Original ResearchConceptsStroke systemsEndovascular acute ischemic stroke therapyIntravenous tissue-type plasminogen activatorAcute ischemic stroke therapyIschemic stroke therapyTissue-type plasminogen activatorCapable centersAppropriate patientsStroke therapyEffective therapyRetrieval therapyMeaningful benefitCommunity settingsTherapyPlasminogen activatorEquitable accessInitial recommendationsData entryPatientsRegistryHospitalTrials
2013
Review of Stroke Center Effectiveness and Other Get with the Guidelines Data
Silva G, Schwamm L. Review of Stroke Center Effectiveness and Other Get with the Guidelines Data. Current Atherosclerosis Reports 2013, 15: 350. PMID: 23892766, DOI: 10.1007/s11883-013-0350-8.Peer-Reviewed Original ResearchConceptsStroke systemsAcute careAcute stroke-ready hospitalGuidelines-Stroke programSpectrum of strokeStroke-ready hospitalsComprehensive stroke centerBest evidence-based careEvidence-based careAmerican Heart AssociationEmergency medical servicesSecondary preventionStroke centersStroke carePrimary preventionHeart AssociationCoordinated careCare processesPatient accessCareCare comprisesStrokeMedical servicesPreventionGuideline data
2012
Patterns, Predictors, Variations, and Temporal Trends in Emergency Medical Service Hospital Prenotification for Acute Ischemic Stroke
Lin C, Peterson E, Smith E, Saver J, Liang L, Xian Y, Olson D, Shah B, Hernandez A, Schwamm L, Fonarow G. Patterns, Predictors, Variations, and Temporal Trends in Emergency Medical Service Hospital Prenotification for Acute Ischemic Stroke. Journal Of The American Heart Association 2012, 1: e002345. PMID: 23130167, PMCID: PMC3487363, DOI: 10.1161/jaha.112.002345.Peer-Reviewed Original ResearchAcute ischemic strokeHospital prenotificationIschemic strokeStroke patientsTissue plasminogen activator administrationGuidelines-Stroke hospitalsPeripheral vascular diseaseHigh annual volumeEMS prenotificationGuidelines-StrokeHospital factorsDiabetes mellitusPatient factorsWhite patientsBlack patientsVascular diseaseStroke systemsPatientsTemporal improvementHospitalOlder ageStrokeTemporal trendsLow usePrenotification
2011
Use of Telemedicine and Other Strategies to Increase the Number of Patients That May Be Treated with Intravenous Thrombolysis
Silva G, Schwamm L. Use of Telemedicine and Other Strategies to Increase the Number of Patients That May Be Treated with Intravenous Thrombolysis. Current Neurology And Neuroscience Reports 2011, 12: 10-16. PMID: 21997715, DOI: 10.1007/s11910-011-0235-6.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeUse of telemedicineIntravenous thrombolysisIschemic strokeIntravenous tissue plasminogen activator useAdult long-term disabilityTissue plasminogen activator useLong-term disabilityAmerican Heart AssociationNumber of patientsRecruitment of patientsRate of treatmentHelp of telemedicineThrombolysis trialsHeart AssociationStroke NetworkStroke systemsTelestroke networkTelestroke systemCurrent evidencePatientsThrombolysisStrokeCareTelemedicine
2009
A Review of the Evidence for the Use of Telemedicine Within Stroke Systems of Care
Schwamm L, Holloway R, Amarenco P, Audebert H, Bakas T, Chumbler N, Handschu R, Jauch E, Knight W, Levine S, Mayberg M, Meyer B, Meyers P, Skalabrin E, Wechsler L. A Review of the Evidence for the Use of Telemedicine Within Stroke Systems of Care. Stroke 2009, 40: 2616-2634. PMID: 19423852, DOI: 10.1161/strokeaha.109.192360.Peer-Reviewed Original ResearchConceptsUse of telemedicineStroke systemsStroke treatmentAmerican Heart Association/American CollegeStroke care deliveryAcute stroke treatmentEvidence-based reviewEvidence-based recommendationsEmergency medical servicesSecondary preventionNeurological assessmentPrimary preventionEmergency departmentCardiology FoundationConsensus recommendationsAmerican CollegeClass of evidenceCare deliveryAvailable evidenceCare frameworkMedical servicesPreventionTelemedicineTreatmentLevel of certaintyRegional Implementation of the Stroke Systems of Care Model
Gropen T, Magdon-Ismail Z, Day D, Melluzzo S, Schwamm L. Regional Implementation of the Stroke Systems of Care Model. Stroke 2009, 40: 1793-1802. PMID: 19299641, DOI: 10.1161/strokeaha.108.531053.Peer-Reviewed Original ResearchMeSH KeywordsEmergency Medical ServicesEvidence-Based MedicineGuidelines as TopicHealth EducationHealth PersonnelHealth Planning SupportHealthcare DisparitiesHumansModels, TheoreticalNew EnglandPatient AdvocacyRegional Medical ProgramsRural PopulationSocioeconomic FactorsStrokeStroke RehabilitationUrban PopulationConceptsStroke systemsCare modelStroke careStroke-related death ratesEmergency medical services dispatchAcute stroke protocolSecondary prevention strategiesContinuum of careEvidence-based interventionsPublic health officialsStroke centersStroke protocolStroke patientsCare measuresStroke resourcesPrevention strategiesHealth professionalsCare deliveryRehabilitation servicesOrder setsDeath rateHealth officialsCareSignificant disparitiesWriting group
2008
Organizing regional stroke systems of care
Park S, Schwamm L. Organizing regional stroke systems of care. Current Opinion In Neurology 2008, 21: 43-55. PMID: 18180651, DOI: 10.1097/wco.0b013e3282f4304d.Peer-Reviewed Original ResearchConceptsStroke treatmentStroke systemsHospital-based stroke careMajor public health problemRegional stroke systemAcute stroke treatmentBetter patient outcomesPublic health problemCare delivery modelsContinuous quality improvement activitiesAcute stroke expertiseAir medical transportEmergency medical servicesHealth policy changesQuality improvement activitiesStroke survivalSecondary preventionStroke unitStroke careThrombolytic therapyPrimary preventionStroke expertisePatient outcomesStroke educationHealth problems