2022
Systematic Review of Sex Differences in Ischemic Strokes Among Young Adults: Are Young Women Disproportionately at Risk?
Leppert M, Burke J, Lisabeth L, Madsen T, Kleindorfer D, Sillau S, Schwamm L, Daugherty S, Bradley C, Ho P, Poisson S. Systematic Review of Sex Differences in Ischemic Strokes Among Young Adults: Are Young Women Disproportionately at Risk? Stroke 2022, 53: 319-327. PMID: 35073188, PMCID: PMC8852306, DOI: 10.1161/strokeaha.121.037117.Peer-Reviewed Original ResearchMeSH KeywordsAdultAge FactorsFemaleHumansIncidenceIschemic StrokeMaleRisk AssessmentSex CharacteristicsSex FactorsYoung AdultConceptsIschemic strokeIncidence rate ratiosYoung adultsStroke incidenceSex-specific incidence rate ratiosSystematic reviewAge groupsSex differencesYoung womenMore womenRate ratioAdults 35Incidence rateStroke typeHigh riskAge adjustmentStrokeSignificant sex differencesRelevant articlesMore menWomenNonsignificant sex differencesAdultsRecent evidenceMen
2021
Association Between Hospital Volumes and Clinical Outcomes for Patients With Nontraumatic Subarachnoid Hemorrhage
Leifer D, Fonarow G, Hellkamp A, Baker D, Hoh B, Prabhakaran S, Schoeberl M, Suter R, Washington C, Williams S, Xian Y, Schwamm L. Association Between Hospital Volumes and Clinical Outcomes for Patients With Nontraumatic Subarachnoid Hemorrhage. Journal Of The American Heart Association 2021, 10: e018373. PMID: 34325522, PMCID: PMC8475679, DOI: 10.1161/jaha.120.018373.Peer-Reviewed Original ResearchConceptsAnnual case volumeComprehensive Stroke Center (CSC) certificationStroke center certificationNational Inpatient SampleSubarachnoid hemorrhageNontraumatic subarachnoid hemorrhageCase volumeHospital mortalityClinical outcomesPoor outcomeCenter certificationSAH casesBetter outcomesVolume thresholdHospital annual case volumeHospital case volumeCases/yearBackground Previous studiesLogistic regression modelsSAH hospitalizationsHospital volumeAneurysm obliterationInpatient SampleOdds ratioImproved outcomes
2020
Target: Stroke Was Associated With Faster Intravenous Thrombolysis and Improved One-Year Outcomes for Acute Ischemic Stroke in Medicare Beneficiaries
Man S, Xian Y, Holmes D, Matsouaka R, Saver J, Smith E, Bhatt D, Schwamm L, Fonarow G. Target: Stroke Was Associated With Faster Intravenous Thrombolysis and Improved One-Year Outcomes for Acute Ischemic Stroke in Medicare Beneficiaries. Circulation Cardiovascular Quality And Outcomes 2020, 13: e007150. PMID: 33302714, DOI: 10.1161/circoutcomes.120.007150.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overDatabases, FactualFemaleFibrinolytic AgentsHumansInfusions, IntravenousInsurance BenefitsIschemic StrokeMaleMedicarePatient ReadmissionQuality ImprovementQuality Indicators, Health CareRetrospective StudiesRisk AssessmentRisk FactorsThrombolytic TherapyTime FactorsTime-to-TreatmentTreatment OutcomeUnited StatesConceptsAcute ischemic strokeIschemic strokeNeedle timeIntravenous thrombolysisCardiovascular readmissionCause mortalityThrombolytic treatmentThrombolytic therapyMedicare beneficiariesGuidelines-Stroke hospitalsIntravenous thrombolytic therapyIntravenous thrombolytic treatmentOne-year outcomesProportion of patientsProportional hazards analysisAmerican Heart AssociationQuality InitiativeCause readmissionMedian doorHospital clusteringMedian ageHeart AssociationHospital characteristicsReadmissionImproved doorDisease Burden Following Non-Cardioembolic Minor Ischemic Stroke or High-Risk TIA: A GWTG-Stroke Study
Kaufman B, Shah S, Hellkamp A, Lytle B, Fonarow G, Schwamm L, Lesén E, Hedberg J, Tank A, Fita E, Bhalla N, Atreja N, Bettger J. Disease Burden Following Non-Cardioembolic Minor Ischemic Stroke or High-Risk TIA: A GWTG-Stroke Study. Journal Of Stroke And Cerebrovascular Diseases 2020, 29: 105399. PMID: 33254370, DOI: 10.1016/j.jstrokecerebrovasdis.2020.105399.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCost-Benefit AnalysisFee-for-Service PlansFemaleFunctional StatusHealth Care CostsHealth Services Needs and DemandHealth Services ResearchHospital CostsHumansIschemic Attack, TransientMaleMedicarePatient DischargeRegistriesRisk AssessmentRisk FactorsSeverity of Illness IndexStrokeTime FactorsTreatment OutcomeUnited StatesConceptsHigh-risk transient ischemic attackTransient ischemic attackMinor ischemic strokeIschemic strokeHigh-risk TIA patientsLimited real-world dataMedicare paymentsBurden of illnessClinical trial populationsMean Medicare paymentsImportant unmet needMedicare spendingIschemic attackTIA patientsAntiplatelet therapyIndex hospitalizationStroke RegistryComposite outcomeCumulative incidenceClinical outcomesTherapeutic optionsTrial populationFunctional statusDisease burdenPatient outcomesEvaluation of stroke incidence with duty‐cycled multielectrode‐phased radiofrequency ablation of persistent atrial fibrillation results of the VICTORY AF Study
Hummel J, Verma A, Calkins H, Schwamm L, Gress D, Wells D, Souza J, Hokanson R, Hemingway L, Stromberg K, Hoyt R, Wickliffe A, DeLurgio D, Boersma L. Evaluation of stroke incidence with duty‐cycled multielectrode‐phased radiofrequency ablation of persistent atrial fibrillation results of the VICTORY AF Study. Journal Of Cardiovascular Electrophysiology 2020, 31: 1289-1297. PMID: 32270538, DOI: 10.1111/jce.14483.Peer-Reviewed Original ResearchConceptsDevice-related strokesAcute procedural successAtrial fibrillationAF trialSecondary outcomesStroke incidenceProcedural successAF studyStroke/transient ischemic attackVitamin K antagonist anticoagulationMajor structural heart diseasePulmonary vein stenosisTransient ischemic attackIncidence of strokeStructural heart diseaseNumber of patientsVitamin K antagonismAtrial fibrillation resultsRigorous clinical evaluationIDE trialIschemic attackNeurologist assessmentPersAF patientsAF burdenPV stenosisCerebral 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 locationDiseaseSafety and Outcomes of Intravenous tPA in Acute Ischemic Stroke Patients With Prior Stroke Within 3 Months
Shah S, Liang L, Kosinski A, Hernandez A, Schwamm L, Smith E, Fonarow G, Bhatt D, Feng W, Peterson E, Xian Y. Safety and Outcomes of Intravenous tPA in Acute Ischemic Stroke Patients With Prior Stroke Within 3 Months. Circulation Cardiovascular Quality And Outcomes 2020, 13: e006031. PMID: 31903770, DOI: 10.1161/circoutcomes.119.006031.Peer-Reviewed Original ResearchMeSH KeywordsAdministrative Claims, HealthcareAgedAged, 80 and overBrain IschemiaDatabases, FactualFemaleFibrinolytic AgentsHospital MortalityHumansInfusions, IntravenousIntracranial HemorrhagesMaleMedicareRecurrenceRegistriesRetrospective StudiesRisk AssessmentRisk FactorsStrokeThrombolytic TherapyTime FactorsTissue Plasminogen ActivatorTreatment OutcomeUnited StatesConceptsAcute ischemic stroke patientsPrior ischemic strokeSymptomatic intracranial hemorrhageIschemic stroke patientsPrior strokeHospital mortalityIntravenous tPAIschemic strokeIntracranial hemorrhageStroke patientsGuidelines-Stroke hospitalsHigher stroke severityGood functional outcomeHistory of strokeRetrospective observational studyYears of ageCardiovascular comorbiditiesStroke providersStroke severityUnadjusted riskFunctional outcomeHigh prevalenceObservational studyMedicare claimsElevated risk
2019
Resource utilisation among patients transferred for intracerebral haemorrhage
Zachrison K, Aaronson E, Mahmood S, Rosand J, Viswanathan A, Schwamm L, Goldstein J. Resource utilisation among patients transferred for intracerebral haemorrhage. Stroke And Vascular Neurology 2019, 4: 223. PMID: 32030206, PMCID: PMC6979870, DOI: 10.1136/svn-2019-000255.Peer-Reviewed Original ResearchMeSH KeywordsAcademic Medical CentersAge FactorsAgedAged, 80 and overCerebral HemorrhageCritical CareFemaleGlasgow Coma ScaleHumansIntensive Care UnitsMaleMiddle AgedNeurosurgical ProceduresPatient AdmissionPatient TransferProspective StudiesRegistriesRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeConceptsGlasgow Coma ScoreIntracerebral hemorrhageSurgical interventionICH scoreAcademic hospitalBaseline Glasgow Coma ScoreIntensive care unit admissionCare unit admissionSingle academic hospitalPrimary intracerebral hemorrhageUrban academic hospitalLess frequent useCollected registryICU stayUnit admissionComa ScoreConsecutive patientsIntraventricular hemorrhagePrimary outcomePrimary patientsPatientsHospitalLogistic regressionHemorrhageResource utilisationIntravenous Tissue Plasminogen Activator in Stroke Mimics
Ali-Ahmed F, Federspiel J, Liang L, Xu H, Sevilis T, Hernandez A, Kosinski A, Prvu Bettger J, Smith E, Bhatt D, Schwamm L, Fonarow G, Peterson E, Xian Y. Intravenous Tissue Plasminogen Activator in Stroke Mimics. Circulation Cardiovascular Quality And Outcomes 2019, 12: e005609. PMID: 31412730, PMCID: PMC6699639, DOI: 10.1161/circoutcomes.119.005609.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, IntravenousAdultAgedAged, 80 and overBrain IschemiaDiagnosis, DifferentialFemaleFibrinolytic AgentsHumansIntracranial HemorrhagesMaleMiddle AgedPredictive Value of TestsRegistriesRisk AssessmentRisk FactorsStrokeThrombolytic TherapyTissue Plasminogen ActivatorTreatment OutcomeUnited StatesUnnecessary ProceduresConceptsTransient ischemic attackStroke mimicsIschemic strokeIschemic attackPrior stroke/transient ischemic attackStroke/transient ischemic attackIntravenous tissue plasminogen activatorGuidelines-Stroke registrySymptomatic intracranial hemorrhageCardiovascular risk factorsHealth Stroke ScaleHospital mortality rateAcute ischemic strokeStroke-like symptomsTissue plasminogen activatorUse of tPANonstroke diagnosisThrombolysis safetyIntravenous tPAStroke ScaleComplication rateIntracranial hemorrhagePresumed strokeRisk factorsFunctional disordersRecent Myocardial Infarction is Associated With Increased Risk in Older Adults With Acute Ischemic Stroke Receiving Thrombolytic Therapy
Inohara T, Liang L, Kosinski A, Smith E, Schwamm L, Hernandez A, Bhatt D, Fonarow G, Peterson E, Xian Y. Recent Myocardial Infarction is Associated With Increased Risk in Older Adults With Acute Ischemic Stroke Receiving Thrombolytic Therapy. Journal Of The American Heart Association 2019, 8: e012450. PMID: 31327296, PMCID: PMC6761665, DOI: 10.1161/jaha.119.012450.Peer-Reviewed Original ResearchConceptsRecombinant tissue-type plasminogen activatorRecent myocardial infarctionAcute ischemic strokeHistory of MIRisk of mortalityMyocardial infarctionAIS patientsIschemic strokeIntravenous recombinant tissue-type plasminogen activatorST-segment elevation myocardial infarctionSegment elevation myocardial infarctionMultivariate logistic regression modelGuidelines-Stroke hospitalsOnly medical therapyElevation myocardial infarctionTissue-type plasminogen activatorLogistic regression modelsHospital mortalityHospital outcomesSevere strokeMedical therapyThrombolytic therapyHigh riskInfarctionPatients
2018
Incidence of Atrial Fibrillation in Patients With Recent Ischemic Stroke Versus Matched Controls
Witsch J, Merkler AE, Chen ML, Navi BB, Sheth KN, Freedman B, Schwamm LH, Kamel H. Incidence of Atrial Fibrillation in Patients With Recent Ischemic Stroke Versus Matched Controls. Stroke 2018, 49: 2529-2531. PMID: 30355110, PMCID: PMC6205716, DOI: 10.1161/strokeaha.118.022826.Peer-Reviewed Original ResearchConceptsAtrial fibrillation/flutterIschemic strokeHemorrhagic strokeAF incidenceAF diagnosisRisk factorsAF-free patientsNew AF diagnosisVascular risk factorsNonstroke diagnosisAutonomic dysfunctionCharlson comorbidityStroke cohortAtrial fibrillationCox regressionNinth RevisionOutpatient claimsIncidental findingClinical ModificationHigh riskInternational ClassificationMedicare beneficiariesSurvival statisticsMatched ControlsPatientsRates, Characteristics, and Outcomes of Patients Transferred to Specialized Stroke Centers for Advanced Care
Ali S, Fonarow G, Liang L, Xian Y, Smith E, Bhatt D, Schwamm L. Rates, Characteristics, and Outcomes of Patients Transferred to Specialized Stroke Centers for Advanced Care. Circulation Cardiovascular Quality And Outcomes 2018, 11: e003359. PMID: 30354551, DOI: 10.1161/circoutcomes.116.003359.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCentralized Hospital ServicesDisability EvaluationFemaleHealthcare DisparitiesHospital MortalityHumansMaleMiddle AgedPatient AdmissionPatient TransferRecovery of FunctionRegistriesRetrospective StudiesRisk AssessmentRisk FactorsStrokeTime FactorsTime-to-TreatmentTreatment OutcomeUnited StatesConceptsSpecialized stroke centersStroke centersHospital mortalityAIS casesPrevious stroke/transient ischemic attackStroke/transient ischemic attackHealth Stroke Scale scoreHigher median National InstitutesWorse short-term outcomesAcute ischemic stroke careGuidelines-Stroke registryMedian National InstitutesOutcomes of patientsStroke Scale scoreTransient ischemic attackShort-term outcomesIschemic stroke careTransfer of patientsMidwest teaching hospitalInstitutional mortality ratesIschemic attackMultivariable adjustmentBaseline characteristicsRankin ScaleClinical outcomesComparison of Acute Ischemic Stroke Care and Outcomes Between Comprehensive Stroke Centers and Primary Stroke Centers in the United States
Man S, Zhao X, Uchino K, Hussain M, Smith E, Bhatt D, Xian Y, Schwamm L, Shah S, Khan Y, Fonarow G. Comparison of Acute Ischemic Stroke Care and Outcomes Between Comprehensive Stroke Centers and Primary Stroke Centers in the United States. Circulation Cardiovascular Quality And Outcomes 2018, 11: e004512. PMID: 29794035, PMCID: PMC5978771, DOI: 10.1161/circoutcomes.117.004512.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBrain IschemiaCertificationComprehensive Health CareDelivery of Health Care, IntegratedEmergency Service, HospitalEndovascular ProceduresFemaleHospital MortalityHospitalsHumansMaleMiddle AgedOutcome and Process Assessment, Health CarePatient AdmissionPatient TransferQuality ImprovementQuality Indicators, Health CareRecovery of FunctionRegistriesRisk AssessmentRisk FactorsStrokeThrombolytic TherapyTime FactorsTime-to-TreatmentTreatment OutcomeUnited StatesConceptsPrimary stroke centerEmergency department admissionsStroke center certificationAcute ischemic strokeIschemic stroke careStroke centersStroke careDepartment admissionsHospital mortalityHospital outcomesIntravenous tPAIschemic strokeCenter certificationTPA timeComprehensive Stroke Center (CSC) certificationAcute ischemic stroke careMultivariable logistic regression modelAcute reperfusion therapyAcute stroke triageBrain Attack CoalitionDefect-free careComprehensive stroke centerOverall care qualityLogistic regression modelsGuidelines-StrokePrestroke selective serotonin reuptake inhibitor use and functional outcomes after ischaemic stroke
Etherton M, Siddiqui K, Schwamm L. Prestroke selective serotonin reuptake inhibitor use and functional outcomes after ischaemic stroke. Stroke And Vascular Neurology 2018, 3: 9. PMID: 29600002, PMCID: PMC5870643, DOI: 10.1136/svn-2017-000119.Peer-Reviewed Original ResearchConceptsSelective serotonin reuptake inhibitorsAcute ischemic strokeIschemic strokeLength of staySSRI useFunctional outcomeSelective serotonin reuptake inhibitor useSerotonin reuptake inhibitor useGuidelines-Stroke registrySerotonin reuptake inhibitorsMultivariate regression analysisAmbulatory statusSymptomatic hemorrhageConsecutive patientsInhibitor useMotor recoveryReuptake inhibitorsFunctional recoveryStroke recoveryUnivariate analysisData registryDrug listMultivariate analysisStrokeLower likelihood
2017
Is Risk-Standardized In-Hospital Stroke Mortality an Adequate Proxy for Risk-Standardized 30-Day Stroke Mortality Data?
Reeves M, Fonarow G, Xu H, Matsouaka R, Xian Y, Saver J, Schwamm L, Smith E. Is Risk-Standardized In-Hospital Stroke Mortality an Adequate Proxy for Risk-Standardized 30-Day Stroke Mortality Data? Circulation Cardiovascular Quality And Outcomes 2017, 10: e003748. PMID: 29021333, DOI: 10.1161/circoutcomes.117.003748.Peer-Reviewed Original ResearchMeSH KeywordsAdministrative Claims, HealthcareAgedAged, 80 and overBrain IschemiaDatabases, FactualFemaleGuideline AdherenceHospice CareHospital MortalityHospitalsHumansMaleMedicarePatient DischargePractice Guidelines as TopicQuality ImprovementQuality Indicators, Health CareRisk AssessmentRisk FactorsStrokeTime FactorsUnited StatesConceptsRisk-standardized mortality ratesHospital mortalityOutlier hospitalsAcute ischemic stroke casesHospital risk-standardized mortality ratesMortality dataGWTG-Stroke hospitalsHospital stroke mortalityIschemic stroke patientsProportion of hospitalsIschemic stroke casesRisk score modelStroke mortality dataChance-corrected agreementComposite outcomeStroke patientsMean ageStroke casesStroke mortalityMedicare filesHospital levelMortality rateLower mortalityHospitalMortality
2016
Relationship Between Language Preference and Intravenous Thrombolysis Among Acute Ischemic Stroke Patients
Erfe B, Siddiqui K, Schwamm L, Mejia N. Relationship Between Language Preference and Intravenous Thrombolysis Among Acute Ischemic Stroke Patients. Journal Of The American Heart Association 2016, 5: e003782. PMID: 27881425, PMCID: PMC5210419, DOI: 10.1161/jaha.116.003782.Peer-Reviewed Original ResearchConceptsLanguage preferencePatients' language preferenceAcute ischemic stroke patientsNon-English languageIschemic stroke patientsNIH Stroke ScaleAIS patientsDifferent languagesInitial NIH stroke scaleIntravenous thrombolysisPatient languageStroke ScaleStroke patientsLanguageStepwise logistic regression modelInitial stroke severityAmerican Heart AssociationEnglishLogistic regression modelsStroke severityMultivariable analysisPatient receiptHeart AssociationThrombolysisPatientsRisks and Benefits Associated With Prestroke Antiplatelet Therapy Among Patients With Acute Ischemic Stroke Treated With Intravenous Tissue Plasminogen Activator
Xian Y, Federspiel J, Grau-Sepulveda M, Hernandez A, Schwamm L, Bhatt D, Smith E, Reeves M, Thomas L, Webb L, Bettger J, Laskowitz D, Fonarow G, Peterson E. Risks and Benefits Associated With Prestroke Antiplatelet Therapy Among Patients With Acute Ischemic Stroke Treated With Intravenous Tissue Plasminogen Activator. JAMA Neurology 2016, 73: 1-10. PMID: 26551916, DOI: 10.1001/jamaneurol.2015.3106.Peer-Reviewed Original ResearchConceptsIntravenous tissue plasminogen activatorSymptomatic intracranial hemorrhageAcute ischemic strokePrestroke antiplatelet therapyTissue plasminogen activatorAntiplatelet therapyIschemic strokeGood functional outcomeHospital mortalityFunctional outcomeHigher oddsPlasminogen activatorDual antiplatelet treatmentGuidelines-Stroke registryRisk-adjusted likelihoodCardiovascular risk factorsRankin Scale scoreAmerican Heart AssociationAntiplatelet treatmentRegistry hospitalsRegistry patientsAmbulatory statusTPA administrationAdult patientsAntiplatelet agents
2014
In Reply
Leffert LR, Schwamm LH. In Reply. Anesthesiology 2014, 120: 1278. PMID: 24755789, DOI: 10.1097/aln.0000000000000164.Peer-Reviewed Original Research
2013
Neuraxial Anesthesia in Parturients with Intracranial Pathology
Leffert LR, Schwamm LH. Neuraxial Anesthesia in Parturients with Intracranial Pathology. Anesthesiology 2013, 119: 703-718. PMID: 23584382, DOI: 10.1097/aln.0b013e31829374c2.Peer-Reviewed Original ResearchRisk-Standardizing Survival for In-Hospital Cardiac Arrest to Facilitate Hospital Comparisons
Chan P, Berg R, Spertus J, Schwamm L, Bhatt D, Fonarow G, Heidenreich P, Nallamothu B, Tang F, Merchant R, Investigators A. Risk-Standardizing Survival for In-Hospital Cardiac Arrest to Facilitate Hospital Comparisons. Journal Of The American College Of Cardiology 2013, 62: 601-609. PMID: 23770167, PMCID: PMC3769937, DOI: 10.1016/j.jacc.2013.05.051.Peer-Reviewed Original Research