2019
Intravenous Tissue-Type Plasminogen Activator in Acute Ischemic Stroke Patients With History of Stroke Plus Diabetes Mellitus
Ehrlich M, Liang L, Xu H, Kosinski A, Hernandez A, Schwamm L, Smith E, Fonarow G, Bhatt D, Peterson E, Xian Y. Intravenous Tissue-Type Plasminogen Activator in Acute Ischemic Stroke Patients With History of Stroke Plus Diabetes Mellitus. Stroke 2019, 50: 1497-1503. PMID: 31035901, PMCID: PMC6538420, DOI: 10.1161/strokeaha.118.024172.Peer-Reviewed Original ResearchConceptsIntravenous tissue-type plasminogen activatorSymptomatic intracerebral hemorrhageAcute ischemic strokeHistory of strokeTissue-type plasminogen activatorIschemic stroke patientsDiabetes mellitusIschemic strokeIntracerebral hemorrhagePlasminogen activatorStroke patientsUnadjusted ratesAcute ischemic stroke patientsBaseline clinical factorsConcomitant diabetes mellitusECASS III trialGuidelines-Stroke registryPrior ischemic strokeCardiovascular risk factorsHospital mortalityPrior strokeSevere strokeIII trialsClinical factorsRisk factors
2018
Quality of Care and Outcomes for Patients With Stroke in the United States Admitted During the International Stroke Conference
Messé S, Mullen M, Cox M, Fonarow G, Smith E, Saver J, Reeves M, Bhatt D, Matsouaka R, Schwamm L. Quality of Care and Outcomes for Patients With Stroke in the United States Admitted During the International Stroke Conference. Journal Of The American Heart Association 2018, 7: e009842. PMID: 30376750, PMCID: PMC6404171, DOI: 10.1161/jaha.118.009842.Peer-Reviewed Original ResearchConceptsIntravenous tissue plasminogen activatorTissue plasminogen activatorAcute ischemic strokeInternational Stroke ConferencePlasminogen activatorWorse outcomesGuideline-adherent careGuidelines-Stroke hospitalsRetrospective cohort studyHours of onsetMinutes of arrivalExperience worse outcomesQuality of careSame quality careAverage weekly numberGuidelines-StrokeAcute strokeBackground PatientsCohort studyConclusions PatientsIschemic strokeClinical outcomesMean ageStroke cliniciansHospital characteristicsShock Index Predicts Patient‐Related Clinical Outcomes in Stroke
Myint P, Sheng S, Xian Y, Matsouaka R, Reeves M, Saver J, Bhatt D, Fonarow G, Schwamm L, Smith E. Shock Index Predicts Patient‐Related Clinical Outcomes in Stroke. Journal Of The American Heart Association 2018, 7: e007581. PMID: 30371191, PMCID: PMC6222962, DOI: 10.1161/jaha.117.007581.Peer-Reviewed Original ResearchConceptsShock indexClinical outcomesWorse outcomesPatient-related clinical outcomesHealth Stroke ScaleBlood pressure componentsAcute stroke casesRankin Scale scoreSystolic blood pressureUseful prognostic indicatorMortality prediction modelIndividual stroke subtypesLinear spline modelsHospital mortalityHospital outcomesHospital stayStroke ScaleAcute strokeDischarge destinationBlood pressureStroke subtypesPoint of carePoor outcomePrognostic valueStroke cases
2017
Association of Preceding Antithrombotic Treatment With Acute Ischemic Stroke Severity and In-Hospital Outcomes Among Patients With Atrial Fibrillation
Xian Y, O’Brien E, Liang L, Xu H, Schwamm L, Fonarow G, Bhatt D, Smith E, Olson D, Maisch L, Hannah D, Lindholm B, Lytle B, Pencina M, Hernandez A, Peterson E. Association of Preceding Antithrombotic Treatment With Acute Ischemic Stroke Severity and In-Hospital Outcomes Among Patients With Atrial Fibrillation. JAMA 2017, 317: 1057-1067. PMID: 28291892, DOI: 10.1001/jama.2017.1371.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeHistory of AFAntithrombotic therapyAntiplatelet therapyAntithrombotic treatmentAtrial fibrillationHospital mortalityTherapeutic warfarinTherapeutic anticoagulationSevere strokeIschemic strokeStroke severityLower oddsSubtherapeutic warfarinUnadjusted ratesAcute ischemic stroke severityGuidelines-Stroke programHealth Stroke ScaleIn-Hospital OutcomesHigh-risk patientsPrevalence of patientsRetrospective observational studyTime of strokeIschemic stroke severityHospital outcomesHealthcare Resource Availability, Quality of Care, and Acute Ischemic Stroke Outcomes
O'Brien E, Wu J, Zhao X, Schulte P, Fonarow G, Hernandez A, Schwamm L, Peterson E, Bhatt D, Smith E. Healthcare Resource Availability, Quality of Care, and Acute Ischemic Stroke Outcomes. Journal Of The American Heart Association 2017, 6: e003813. PMID: 28159820, PMCID: PMC5523738, DOI: 10.1161/jaha.116.003813.Peer-Reviewed Original ResearchConceptsHealthcare resource availabilityHospital referral regionsQuality of careReferral regionsHealthcare resourcesAcute ischemic stroke outcomesAcute ischemic stroke treatmentGuidelines-Stroke hospitalsIschemic stroke outcomeIschemic stroke patientsIschemic stroke treatmentMultivariable logistic regressionLength of stayHospital-based resourcesGuidelines-StrokeHospital mortalityHospital outcomesStroke outcomeStroke careStroke treatmentStroke patientsCare resourcesHealth care dataHospital qualityStroke quality
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 AssociationThrombolysisPatients
2015
Smoking Paradox in Patients Hospitalized With Coronary Artery Disease or Acute Ischemic Stroke
Ali S, Smith E, Reeves M, Zhao X, Xian Y, Hernandez A, Bhatt D, Fonarow G, Schwamm L. Smoking Paradox in Patients Hospitalized With Coronary Artery Disease or Acute Ischemic Stroke. Circulation Cardiovascular Quality And Outcomes 2015, 8: s73-s80. PMID: 26515213, DOI: 10.1161/circoutcomes.114.001244.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeCoronary artery diseaseVascular risk factorsAdjusted odds ratioHospital mortalityRisk factorsIschemic strokeArtery diseaseOdds ratioProspective population-based studyPast-year smokersResidual unmeasured confoundingPopulation-based studyAge-stratified analysisPotent risk factorPast-year smokingConsecutive patientsMultivariable modelSmokersSmokingPatientsSignificant associationMortalitySubstantial confoundingUnmeasured confoundingVariation and Trends in the Documentation of National Institutes of Health Stroke Scale in GWTG-Stroke Hospitals
Reeves M, Smith E, Fonarow G, Zhao X, Thompson M, Peterson E, Schwamm L, Olson D. Variation and Trends in the Documentation of National Institutes of Health Stroke Scale in GWTG-Stroke Hospitals. Circulation Cardiovascular Quality And Outcomes 2015, 8: s90-s98. PMID: 26515215, DOI: 10.1161/circoutcomes.115.001775.Peer-Reviewed Original ResearchConceptsGWTG-Stroke hospitalsHealth Stroke ScaleNIHSS scoreDocumentation ratesNIHSS dataStroke ScaleMultivariable logistic regression modelAcute ischemic strokeHospital-level factorsPrimary stroke centerImportant prognostic variablesPatient-level predictorsNational InstituteLogistic regression modelsMedian NIHSSIschemic strokeStroke centersThrombolysis candidatesClinical registryPrognostic variablesNIHSSHospitalPatientsStrokeLow documentationAssociation of Acute and Chronic Hyperglycemia With Acute Ischemic Stroke Outcomes Post‐Thrombolysis: Findings From Get With The Guidelines‐Stroke
Masrur S, Cox M, Bhatt D, Smith E, Ellrodt G, Fonarow G, Schwamm L. Association of Acute and Chronic Hyperglycemia With Acute Ischemic Stroke Outcomes Post‐Thrombolysis: Findings From Get With The Guidelines‐Stroke. Journal Of The American Heart Association 2015, 4: e002193. PMID: 26408015, PMCID: PMC4845108, DOI: 10.1161/jaha.115.002193.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAgedAged, 80 and overBiomarkersBlood GlucoseBrain IschemiaChi-Square DistributionChronic DiseaseFemaleFibrinolytic AgentsGlycated HemoglobinGuideline AdherenceHospital MortalityHumansHyperglycemiaLength of StayLogistic ModelsMaleMiddle AgedMultivariate AnalysisOdds RatioPractice Guidelines as TopicPractice Patterns, Physicians'RegistriesRetrospective StudiesRisk FactorsStrokeThrombolytic TherapyTime FactorsTissue Plasminogen ActivatorTreatment OutcomeUnited StatesConceptsTissue plasminogen activatorAssociation of acuteAcute ischemic strokeHistory of diabetesWorse clinical outcomesChronic hyperglycemiaClinical outcomesGuidelines-StrokeHospital mortalityAIS patientsBlood glucoseGlucose levelsPlasma glucose levelsBlood glucose levelsAdmission glucoseNondiabetic patientsPost thrombolysisIschemic strokeAcute hyperglycemiaDL increaseAcute correctionPoor outcomeAdverse outcomesOdds ratioHyperglycemia
2014
Chronic Kidney Disease and Bleeding Complications After Intravenous Thrombolytic Therapy for Acute Ischemic Stroke
Ovbiagele B, Smith E, Schwamm L, Grau-Sepulveda M, Saver J, Bhatt D, Hernandez A, Peterson E, Fonarow G. Chronic Kidney Disease and Bleeding Complications After Intravenous Thrombolytic Therapy for Acute Ischemic Stroke. Circulation Cardiovascular Quality And Outcomes 2014, 7: 929-935. PMID: 25249561, DOI: 10.1161/circoutcomes.114.001144.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAgedBrain IschemiaFemaleFibrinolytic AgentsFollow-Up StudiesGlomerular Filtration RateHemorrhageHospital MortalityHumansIncidenceInjections, IntravenousMaleOdds RatioRegistriesRenal Insufficiency, ChronicRetrospective StudiesThrombolytic TherapyTime FactorsTissue Plasminogen ActivatorUnited StatesConceptsChronic kidney diseaseSerious systemic hemorrhageSymptomatic intracranial hemorrhagePresence of CKDIntravenous tissue-type plasminogen activatorIntracranial hemorrhageSystemic hemorrhageTissue-type plasminogen activatorKidney diseaseFunctional statusTissue-type plasminogen activator administrationPlasminogen activatorAdmission serum creatinineGuidelines-Stroke programIndependent functional statusIntravenous thrombolytic therapyPrimary end pointAcute ischemic strokeIschemic stroke patientsGlomerular filtration rateNormal kidney functionDischarge functional statusHigher unadjusted oddsTissue-type plasminogenHospital mortality
2013
Comparison of Performance Achievement Award Recognition With Primary Stroke Center Certification for Acute Ischemic Stroke Care
Fonarow G, Liang L, Smith E, Reeves M, Saver J, Xian Y, Hernandez A, Peterson E, Schwamm L, Committee & Investigators G. Comparison of Performance Achievement Award Recognition With Primary Stroke Center Certification for Acute Ischemic Stroke Care. Journal Of The American Heart Association 2013, 2: e000451. PMID: 24125846, PMCID: PMC3835260, DOI: 10.1161/jaha.113.000451.Peer-Reviewed Original ResearchConceptsPrimary stroke center certificationStroke center certificationAcute ischemic strokeHospital characteristicsIschemic strokeCenter certificationAcute ischemic stroke careStroke performance measuresIschemic stroke careAmerican Heart AssociationPSC certificationPatient characteristicsStroke careStroke measuresHeart AssociationCare measuresHigher oddsPatientsHospitalPSC statusStroke qualityHospital certificationStrokeCareA Trial of Imaging Selection and Endovascular Treatment for Ischemic Stroke
Kidwell C, Jahan R, Gornbein J, Alger J, Nenov V, Ajani Z, Feng L, Meyer B, Olson S, Schwamm L, Yoo A, Marshall R, Meyers P, Yavagal D, Wintermark M, Guzy J, Starkman S, Saver J. A Trial of Imaging Selection and Endovascular Treatment for Ischemic Stroke. New England Journal Of Medicine 2013, 368: 914-923. PMID: 23394476, PMCID: PMC3690785, DOI: 10.1056/nejmoa1212793.Peer-Reviewed Original ResearchConceptsFavorable penumbral patternAcute ischemic strokeStandard carePenumbral patternIschemic strokeRankin ScaleNinety-day mortalitySymptomatic intracranial hemorrhageAnterior circulation strokeModified Rankin ScaleMagnetic resonance imagingEligible patientsEmbolectomy groupMechanical embolectomyEndovascular thrombectomyEndovascular therapySuch patientsClinical outcomesEndovascular treatmentIntracranial hemorrhageMean ageImaging selectionImaging patternsEmbolectomyPatients
2012
Comparison of 30-Day Mortality Models for Profiling Hospital Performance in Acute Ischemic Stroke With vs Without Adjustment for Stroke Severity
Fonarow G, Pan W, Saver J, Smith E, Reeves M, Broderick J, Kleindorfer D, Sacco R, Olson D, Hernandez A, Peterson E, Schwamm L. Comparison of 30-Day Mortality Models for Profiling Hospital Performance in Acute Ischemic Stroke With vs Without Adjustment for Stroke Severity. JAMA 2012, 308: 257-264. PMID: 22797643, DOI: 10.1001/jama.2012.7870.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeNIHSS scoreInitial stroke severityIschemic strokeStroke severityMedicare beneficiariesClaims-based risk modelsHospital mortality modelMean NIHSS scoreRisk-standardized outcomesHealth Stroke ScaleNet reclassification improvementDiscrimination improvement indexService Medicare beneficiariesHospital mortality risk modelMortality risk modelProfiling Hospital PerformanceGuidelines-StrokeIndex hospitalizationStroke ScaleReclassification improvementRisk modelModel discriminationPotential eligibilityStudy populationRisks of Intracranial Hemorrhage Among Patients With Acute Ischemic Stroke Receiving Warfarin and Treated With Intravenous Tissue Plasminogen Activator
Xian Y, Liang L, Smith E, Schwamm L, Reeves M, Olson D, Hernandez A, Fonarow G, Peterson E. Risks of Intracranial Hemorrhage Among Patients With Acute Ischemic Stroke Receiving Warfarin and Treated With Intravenous Tissue Plasminogen Activator. JAMA 2012, 307: 2600-2608. PMID: 22735429, DOI: 10.1001/jama.2012.6756.Peer-Reviewed Original ResearchConceptsIntravenous tissue plasminogen activatorInternational normalized ratioSymptomatic intracranial hemorrhageTissue plasminogen activatorSerious systemic hemorrhageIschemic strokeIntracranial hemorrhageSICH riskHospital mortalitySystemic hemorrhagePlasminogen activatorBaseline clinical factorsChronic warfarin therapyGuidelines-Stroke registrySecondary end pointsDegree of anticoagulationAmerican Heart AssociationRegistry hospitalsSICH rateSevere strokeWarfarin therapyClinical factorsComorbid conditionsHeart AssociationNormalized ratioSex differences in in-hospital mortality in acute decompensated heart failure with reduced and preserved ejection fraction
Hsich E, Grau-Sepulveda M, Hernandez A, Peterson E, Schwamm L, Bhatt D, Fonarow G. Sex differences in in-hospital mortality in acute decompensated heart failure with reduced and preserved ejection fraction. American Heart Journal 2012, 163: 430-437.e3. PMID: 22424014, DOI: 10.1016/j.ahj.2011.12.013.Peer-Reviewed Original ResearchConceptsHospital mortalityHeart failureRisk factorsHF patientsEjection fractionAcute decompensated heart failureRenal failure/dialysisGuidelines-Heart FailureDecompensated heart failurePrimary end pointPeripheral vascular diseaseSystolic blood pressureCoronary artery diseaseValvular heart diseaseEquation logistic modelsSex differencesMulticenter registryBaseline characteristicsArtery diseaseBlood pressureHospital clusteringHospitalized patientsStudy cohortVascular diseaseHeart diseaseCare and Outcomes of Asian-American Acute Myocardial Infarction Patients
Qian F, Ling F, Deedwania P, Hernandez A, Fonarow G, Cannon C, Peterson E, Peacock W, Kaltenbach L, Laskey W, Schwamm L, Bhatt D. Care and Outcomes of Asian-American Acute Myocardial Infarction Patients. Circulation Cardiovascular Quality And Outcomes 2012, 5: 126-133. PMID: 22235068, DOI: 10.1161/circoutcomes.111.961987.Peer-Reviewed Original ResearchConceptsGuidelines-Coronary Artery Disease programAcute myocardial infarctionAMI patientsDisease programsBalloon timeWhite patientsAcute myocardial infarction patientsAMI performance measuresDefect-free careHospital mortality rateEvidence-based careAmerican Heart AssociationMyocardial infarction patientsAsian American patientsUnited States CentersHospital mortalityCessation counselingUnadjusted mortalityHeart failureHeart AssociationInfarction patientsMyocardial infarctionHigh prevalenceClinical careMortality rate
2011
A Qualitative Assessment of Practices Associated With Shorter Door-to-Needle Time for Thrombolytic Therapy in Acute Ischemic Stroke
Olson D, Constable M, Britz G, Lin C, Zimmer L, Schwamm L, Fonarow G, Peterson E. A Qualitative Assessment of Practices Associated With Shorter Door-to-Needle Time for Thrombolytic Therapy in Acute Ischemic Stroke. Journal Of Neuroscience Nursing 2011, 43: 329-336. PMID: 22089410, DOI: 10.1097/jnn.0b013e318234e7fb.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeNeedle timeIschemic strokeStroke patientsGoal of doorQualitative telephone interviewsThrombolytic therapyEarly treatmentImproved outcomesTPA deliveryRapid triageHermeneutic phenomenological frameworkTelephone interviewsPatientsU.S. hospitalsStrokeHospitalFaster treatmentTreatmentNovel factorOvercoming barriersElicit strategiesAlteplaseQualitative assessmentTherapyTimeliness of Tissue-Type Plasminogen Activator Therapy in Acute Ischemic Stroke
Fonarow G, Smith E, Saver J, Reeves M, Bhatt D, Grau-Sepulveda M, Olson D, Hernandez A, Peterson E, Schwamm L. Timeliness of Tissue-Type Plasminogen Activator Therapy in Acute Ischemic Stroke. Circulation 2011, 123: 750-758. PMID: 21311083, DOI: 10.1161/circulationaha.110.974675.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAgedAged, 80 and overAmerican Heart AssociationBrain IschemiaEmergency Medical ServicesFemaleFibrinolytic AgentsGuideline AdherenceHumansMaleMiddle AgedOutcome Assessment, Health CarePractice Guidelines as TopicRisk FactorsStrokeTime FactorsTissue Plasminogen ActivatorUnited StatesConceptsAcute ischemic strokeIntravenous tissue-type plasminogen activatorTissue-type plasminogen activatorIschemic stroke patientsNeedle timeIschemic strokeStroke patientsAcute ischemic stroke patientsGuidelines-Stroke programSimilar stroke severitySymptomatic intracranial hemorrhageTimeliness of reperfusionProportion of patientsPlasminogen activator therapyTreatment initiation timeMinute doorPrior strokeHospital mortalityHospital factorsStroke severitySymptom onsetPatient factorsActivator therapyIntracranial hemorrhageHospital characteristics
2010
Hospital-Level Variation in Mortality and Rehospitalization for Medicare Beneficiaries With Acute Ischemic Stroke
Fonarow G, Smith E, Reeves M, Pan W, Olson D, Hernandez A, Peterson E, Schwamm L. Hospital-Level Variation in Mortality and Rehospitalization for Medicare Beneficiaries With Acute Ischemic Stroke. Stroke 2010, 42: 159-166. PMID: 21164109, DOI: 10.1161/strokeaha.110.601831.Peer-Reviewed Original ResearchConceptsIschemic strokeMedicare beneficiariesReadmission ratesPrimary stroke center designationGuidelines-Stroke hospitalsHospital-level outcomesStroke center designationAcute ischemic strokeCause readmission rateIschemic stroke mortalityHospital-level variationCause of deathRisk-adjusted outcomesHospital-level performanceRisk-adjusted ratesHospital dischargeRehospitalization ratesUnadjusted mortalityHospital admissionMean ageCenter designationStroke mortalityFavorable outcomeAcademic hospitalOutcome dataPatient-Level and Hospital-Level Determinants of the Quality of Acute Stroke Care
Reeves M, Gargano J, Maier K, Broderick J, Frankel M, LaBresh K, Moomaw C, Schwamm L. Patient-Level and Hospital-Level Determinants of the Quality of Acute Stroke Care. Stroke 2010, 41: 2924-2931. PMID: 20966407, DOI: 10.1161/strokeaha.110.598664.Peer-Reviewed Original ResearchConceptsHospital-level determinantsAcute stroke careQuality of careStroke RegistryStroke carePatient levelPaul Coverdell National Acute Stroke RegistryNational Acute Stroke RegistryAcute Stroke RegistryHospital-level factorsPatient-level factorsHospital-level variablesPatient-level variablesComposite scoreMultilevel linear regression analysesMean composite scoreTIA admissionsHospital factorsIschemic strokeStatus documentationRegistry dataLinear regression analysisHospitalNeurologist involvementSmall hospitals