2019
Hospital distance, socioeconomic status, and timely treatment of ischemic stroke.
Ader J, Wu J, Fonarow GC, Smith EE, Shah S, Xian Y, Bhatt DL, Schwamm LH, Reeves MJ, Matsouaka RA, Sheth KN. Hospital distance, socioeconomic status, and timely treatment of ischemic stroke. Neurology 2019, 93: e747-e757. PMID: 31320472, PMCID: PMC6711658, DOI: 10.1212/wnl.0000000000007963.Peer-Reviewed Original ResearchConceptsTPA administrationHome zip codeSocioeconomic statusHospital mortalityTime quartilesLower oddsHierarchical multivariable logistic regression modelsTissue plasminogen activator administrationPatient's home zip codeMultivariable logistic regression modelZip code median household incomeGuidelines-Stroke registryPatients' socioeconomic statusRetrospective observational studyLow socioeconomic statusEmergency medical servicesLogistic regression modelsLowest SES quintileHigher socioeconomic statusShorter OTTIschemic strokeSecondary outcomesPatient agePrimary outcomeObservational studyComparison of Clinical Care and In-Hospital Outcomes of Asian American and White Patients With Acute Ischemic Stroke
Song S, Liang L, Fonarow G, Smith E, Bhatt D, Matsouaka R, Xian Y, Schwamm L, Saver J. Comparison of Clinical Care and In-Hospital Outcomes of Asian American and White Patients With Acute Ischemic Stroke. JAMA Neurology 2019, 76: 430-439. PMID: 30667466, PMCID: PMC6459126, DOI: 10.1001/jamaneurol.2018.4410.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAsianBrain IschemiaFemaleFibrinolytic AgentsHealthcare DisparitiesHospital MortalityHumansHydroxymethylglutaryl-CoA Reductase InhibitorsIntracranial HemorrhagesLogistic ModelsMaleMiddle AgedMultivariate AnalysisPatient DischargeQuality of Health CareRetrospective StudiesSeverity of Illness IndexStrokeStroke RehabilitationThrombolytic TherapyTime-to-TreatmentTissue Plasminogen ActivatorTreatment OutcomeUnited StatesWhite PeopleConceptsAcute ischemic strokeAsian American patientsIschemic strokeWhite patientsAmerican patientsClinical outcomesHospital mortalityStroke severityAmerican Heart Association/American Stroke AssociationIntravenous tissue plasminogen activator administrationTissue plasminogen activator administrationMultivariable logistic regression modelGreater stroke severityGuidelines-Stroke programGWTG-Stroke hospitalsIntensive statin therapyOverall stroke incidenceIn-Hospital OutcomesSevere ischemic strokeWorse functional outcomeAmerican Stroke AssociationQuality improvement registryLogistic regression modelsRace/ethnicityStatin therapy
2015
FLAIR Vascular Hyperintensity is a Surrogate of Collateral Flow and Leukoaraiosis in Patients With Acute Stroke Due to Proximal Artery Occlusion
Karadeli H, Giurgiutiu D, Cloonan L, Fitzpatrick K, Kanakis A, Ozcan M, Schwamm L, Rost N. FLAIR Vascular Hyperintensity is a Surrogate of Collateral Flow and Leukoaraiosis in Patients With Acute Stroke Due to Proximal Artery Occlusion. Journal Of Neuroimaging 2015, 26: 219-223. PMID: 26250448, PMCID: PMC4744593, DOI: 10.1111/jon.12274.Peer-Reviewed Original ResearchConceptsProximal artery occlusionCollateral flow gradeFlow gradeAIS patientsWhite matter hyperintensitiesWMH volumeCT angiographyFVH scoreVascular hyperintensityArtery occlusionIntravenous tissue plasminogen activator administrationInversion recovery vascular hyperintensityAcute ischemic stroke patientsTissue plasminogen activator administrationAdmission CT angiographyBaseline CT angiographyCollateral vessel statusFLAIR vascular hyperintensityLeptomeningeal collateral statusMedian WMH volumeSalvageable brain tissueConsecutive AIS patientsIschemic stroke patientsWorse clinical outcomesAcute MRI
2014
Door-to-Needle Times for Tissue Plasminogen Activator Administration and Clinical Outcomes in Acute Ischemic Stroke Before and After a Quality Improvement Initiative
Fonarow G, Zhao X, Smith E, Saver J, Reeves M, Bhatt D, Xian Y, Hernandez A, Peterson E, Schwamm L. Door-to-Needle Times for Tissue Plasminogen Activator Administration and Clinical Outcomes in Acute Ischemic Stroke Before and After a Quality Improvement Initiative. JAMA 2014, 311: 1632-1640. PMID: 24756513, DOI: 10.1001/jama.2014.3203.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBrain IschemiaDecision Support Systems, ClinicalFemaleFibrinolytic AgentsGuideline AdherenceHospital MortalityHospitalsHumansIntracranial HemorrhagesMaleMiddle AgedPatient DischargeQuality ImprovementRegistriesStrokeThrombolytic TherapyTissue Plasminogen ActivatorTreatment OutcomeConceptsAcute ischemic strokeQuality improvement initiativesTissue plasminogen activatorNational quality improvement initiativeSymptomatic intracranial hemorrhageDTN timeTPA administrationIntracranial hemorrhagePostintervention periodIschemic strokeNeedle timeClinical outcomesPreintervention periodImprovement initiativesHospital risk-adjusted mortalityIntravenous tissue plasminogen activatorTissue plasminogen activator administrationMedian DTN timePercentage of patientsProportion of patientsClinical decision support toolRisk-adjusted mortalityGuidelines-StrokeHospital mortalityYear preintervention
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