2024
Trends in Stroke Thrombolysis Care Metrics and Outcomes by Race and Ethnicity, 2003-2021
Man S, Solomon N, Mac Grory B, Alhanti B, Saver J, Smith E, Xian Y, Bhatt D, Schwamm L, Uchino K, Fonarow G. Trends in Stroke Thrombolysis Care Metrics and Outcomes by Race and Ethnicity, 2003-2021. JAMA Network Open 2024, 7: e2352927. PMID: 38324315, PMCID: PMC10851100, DOI: 10.1001/jamanetworkopen.2023.52927.Peer-Reviewed Original ResearchConceptsDoor-to-needleDoor-to-needle timeHispanic patientsWhite patientsAssociated with improvementsThrombolysis rateCohort studyEthnic groupsQuality InitiativeCohort study of patientsCare qualityCare metricsPre-testIschemic strokeEthnic disparitiesRetrospective cohort studyMain OutcomesPatient functionIschemic stroke onsetSecondary outcomesPrimary outcomeStudy of patientsOddsAcute ischemic strokeStroke onset
2022
Temporal Trends in Racial and Ethnic Disparities in Endovascular Therapy in Acute Ischemic Stroke
Sheriff F, Xu H, Maud A, Gupta V, Vellipuram A, Fonarow G, Matsouaka R, Xian Y, Reeves M, Smith E, Saver J, Rodriguez G, Cruz‐Flores S, Schwamm L. Temporal Trends in Racial and Ethnic Disparities in Endovascular Therapy in Acute Ischemic Stroke. Journal Of The American Heart Association 2022, 11: e023212. PMID: 35229659, PMCID: PMC9075329, DOI: 10.1161/jaha.121.023212.Peer-Reviewed Original ResearchMeSH KeywordsEndovascular ProceduresEthnicityHispanic or LatinoHumansIschemic StrokeStrokeTreatment OutcomeConceptsAcute ischemic strokeEndovascular therapyEVT useIschemic strokeNon-Hispanic white patientsGuidelines-Stroke databaseHealth Stroke ScaleMortality/dischargeClinical trial publicationsPatient disparitiesDischarge homeEligible patientsNHW patientsStroke ScaleWhite patientsBlack patientsAsian patientsFunctional outcomeLarge cohortTrial publicationsPatientsFunctional independenceEthnic disparitiesRelated outcomesNational InstituteRace-Ethnic Disparities in Rates of Declination of Thrombolysis for Stroke
Mendelson S, Zhang S, Matsouaka R, Xian Y, Shah S, Lytle B, Solomon N, Schwamm L, Smith E, Saver J, Fonarow G, Holl J, Prabhakaran S. Race-Ethnic Disparities in Rates of Declination of Thrombolysis for Stroke. Neurology 2022, 98: e1596-e1604. PMID: 35228335, PMCID: PMC9052571, DOI: 10.1212/wnl.0000000000200138.Peer-Reviewed Original ResearchConceptsTissue plasminogen activatorNon-Hispanic black patientsTPA-eligible patientsRace/ethnicityBlack patientsNon-Hispanic black race/ethnicityNon-Hispanic white patientsBlack race/ethnicityAsian race/ethnicityGuidelines-Stroke registryPrimary stroke centerSingle-center studyMultivariable logistic regressionRace-ethnic disparitiesNon-Hispanic whitesEligible patientsHospital factorsNationwide registryPatient demographicsStroke centersSymptom onsetWhite patientsMultivariable analysisStroke careAsian patients
2021
Association of Physician Characteristics With Early Adoption of Virtual Health Care
Zachrison K, Yan Z, Samuels-Kalow M, Licurse A, Zuccotti G, Schwamm L. Association of Physician Characteristics With Early Adoption of Virtual Health Care. JAMA Network Open 2021, 4: e2141625. PMID: 34967876, PMCID: PMC8719243, DOI: 10.1001/jamanetworkopen.2021.41625.Peer-Reviewed Original ResearchConceptsVirtual health careCross-sectional studyHealth care systemPatient characteristicsHealth carePhysician characteristicsLarge regional health care systemRetrospective cross-sectional studyBehavioral healthCare systemSurgical specialtiesHealth system databasePhysician-level variationRegional health care systemAmbulatory visitsPrimary careHealth physiciansPatient's abilityAmbulatory careMAIN OUTCOMEGreater oddsAmbulatory practiceBivariate comparisonsPhysiciansHospital affiliation
2017
Professional Medical Interpreters Influence the Quality of Acute Ischemic Stroke Care for Patients Who Speak Languages Other than English
Erfe B, Siddiqui K, Schwamm L, Kirwan C, Nunes A, Mejia N. Professional Medical Interpreters Influence the Quality of Acute Ischemic Stroke Care for Patients Who Speak Languages Other than English. Journal Of The American Heart Association 2017, 6: e006175. PMID: 28935679, PMCID: PMC5634277, DOI: 10.1161/jaha.117.006175.Peer-Reviewed Original ResearchConceptsProfessional medical interpretersMedical interpretersAcute ischemic stroke careIschemic stroke careAcute ischemic stroke patientsIschemic stroke patientsStroke carePMI servicesCommon languageEnglishLanguageStroke patientsInterpretersGuidelines-Stroke programAmerican Heart AssociationAppropriate health careLogistic regression modelsQuality patient careHospital stayMultivariable analysisPatient receiptHeart AssociationLower oddsPatientsMedical care
2016
Sex and Race/Ethnicity Differences in Implantable Cardioverter-Defibrillator Counseling and Use Among Patients Hospitalized With Heart Failure
Hess P, Hernandez A, Bhatt D, Hellkamp A, Yancy C, Schwamm L, Peterson E, Schulte P, Fonarow G, Al-Khatib S. Sex and Race/Ethnicity Differences in Implantable Cardioverter-Defibrillator Counseling and Use Among Patients Hospitalized With Heart Failure. Circulation 2016, 134: 517-526. PMID: 27492903, DOI: 10.1161/circulationaha.115.021048.Peer-Reviewed Original ResearchConceptsHeart failureWhite patientsHispanic patientsBlack patientsGuidelines-Heart Failure programRace/ethnicity differencesRace/ethnicityEligible patientsHospital stayEjection fractionPrimary preventionMinority patientsPatientsICDWomenCounselingMenEthnicity differencesObservational analysisSexFailureEthnicityPrevious studiesStayEthnic minorities
2014
Racial/Ethnic Differences in Process of Care and Outcomes Among Patients Hospitalized With Intracerebral Hemorrhage
Xian Y, Holloway R, Smith E, Schwamm L, Reeves M, Bhatt D, Schulte P, Cox M, Olson D, Hernandez A, Lytle B, Anstrom K, Fonarow G, Peterson E. Racial/Ethnic Differences in Process of Care and Outcomes Among Patients Hospitalized With Intracerebral Hemorrhage. Stroke 2014, 45: 3243-3250. PMID: 25213344, DOI: 10.1161/strokeaha.114.005620.Peer-Reviewed Original ResearchConceptsWhite patientsAsian patientsRace/ethnicityCessation counselingLower oddsDeep venous thrombosis prophylaxisGuidelines-Stroke hospitalsStroke performance measuresVenous thrombosis prophylaxisHospital-level characteristicsMultivariable logistic regressionProcess of careEthnic differencesHospital mortalityThrombosis prophylaxisCause mortalityHospital outcomesSevere strokeDysphagia screeningBlack patientsIntracerebral hemorrhageMedian lengthHigher oddsStroke educationComfort measures
2013
Racial and Ethnic Differences in Outcomes in Older Patients With Acute Ischemic Stroke
Qian F, Fonarow G, Smith E, Xian Y, Pan W, Hannan E, Shaw B, Glance L, Peterson E, Eapen Z, Hernandez A, Schwamm L, Bhatt D. Racial and Ethnic Differences in Outcomes in Older Patients With Acute Ischemic Stroke. Circulation Cardiovascular Quality And Outcomes 2013, 6: 284-292. PMID: 23680966, DOI: 10.1161/circoutcomes.113.000211.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overBlack or African AmericanBrain IschemiaEthnicityFemaleHealth Status DisparitiesHealthcare DisparitiesHispanic or LatinoHumansLogistic ModelsMaleMedicareMultivariate AnalysisOdds RatioPatient ReadmissionRacial GroupsRegistriesRisk FactorsSeverity of Illness IndexStrokeTime FactorsTreatment OutcomeUnited StatesWhite PeopleConceptsAcute ischemic strokeLong-term outcomesRace/ethnicityCause rehospitalizationOlder patientsIschemic strokeUnadjusted mortalityHispanic patientsGuidelines-Stroke programGuidelines-Stroke registryHealth Stroke ScaleOlder Medicare beneficiariesAmerican Heart AssociationAsian American patientsYears of ageStroke ScaleStroke severityHigher median scoresAsian patientsHeart AssociationHospital characteristicsAmerican patientsUS CentersPrognostic variablesLower oddsPatterns of Emergency Medical Services Use and Its Association With Timely Stroke Treatment
Ekundayo O, Saver J, Fonarow G, Schwamm L, Xian Y, Zhao X, Hernandez A, Peterson E, Cheng E. Patterns of Emergency Medical Services Use and Its Association With Timely Stroke Treatment. Circulation Cardiovascular Quality And Outcomes 2013, 6: 262-269. PMID: 23633218, DOI: 10.1161/circoutcomes.113.000089.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overChi-Square DistributionEmergency Medical ServicesEmergency Service, HospitalEthnicityFemaleGuideline AdherenceHealth Knowledge, Attitudes, PracticeHumansMaleMiddle AgedMinority GroupsOdds RatioOutcome and Process Assessment, Health CarePatient Acceptance of Health CarePatient Education as TopicPractice Guidelines as TopicRegistriesRisk FactorsStrokeTime FactorsTime-to-TreatmentTransportation of PatientsTreatment OutcomeUnited StatesConceptsEmergency medical servicesStroke patientsEMS useEmergency medical services useMinority raceHealth Stroke ScoreMedical service useTreatment of strokeTissue-type plasminogen activatorEligible patientsGuidelines-StrokeSevere strokeStroke ScoreHospital arrivalOlder patientsYounger patientsHemorrhagic strokeStroke treatmentMedicare insuranceInsurance statusEMS activationDecreased oddsEMS transportService usePatientsComparison of Ischemic Stroke Outcomes and Patient and Hospital Characteristics by Race/Ethnicity and Socioeconomic Status
Hanchate A, Schwamm L, Huang W, Hylek E. Comparison of Ischemic Stroke Outcomes and Patient and Hospital Characteristics by Race/Ethnicity and Socioeconomic Status. Stroke 2013, 44: 469-476. PMID: 23306327, PMCID: PMC3595403, DOI: 10.1161/strokeaha.112.669341.Peer-Reviewed Original ResearchConceptsRace/ethnicityAcute ischemic strokeInpatient mortalityRisk-adjusted ratesIschemic strokeSocioeconomic statusBlack patientsArea patientsNonfederal acute care hospitalsRisk-adjusted inpatient mortalityIschemic stroke outcomeInpatient mortality rateIschemic stroke admissionsCrude inpatient mortality rateLength of stayPatient's zip codeAcute care hospitalsLonger lengthStroke admissionsStroke outcomeStroke severityCare hospitalDischarge outcomesWhite patientsMechanical ventilation
2012
Risk Score for Intracranial Hemorrhage in Patients With Acute Ischemic Stroke Treated With Intravenous Tissue-Type Plasminogen Activator
Menon B, Saver J, Prabhakaran S, Reeves M, Liang L, Olson D, Peterson E, Hernandez A, Fonarow G, Schwamm L, Smith E. Risk Score for Intracranial Hemorrhage in Patients With Acute Ischemic Stroke Treated With Intravenous Tissue-Type Plasminogen Activator. Stroke 2012, 43: 2293-2299. PMID: 22811458, DOI: 10.1161/strokeaha.112.660415.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBlood PressureCerebral HemorrhageCohort StudiesData Interpretation, StatisticalEthnicityFemaleFibrinolytic AgentsHospitalsHumansLogistic ModelsMaleMiddle AgedMultivariate AnalysisPredictive Value of TestsRisk AssessmentRisk FactorsStrokeTissue Plasminogen ActivatorTreatment OutcomeConceptsIntravenous tissue-type plasminogen activatorSymptomatic intracranial hemorrhageTissue-type plasminogen activatorSICH riskIschemic strokeSymptom onsetIntracranial hemorrhageValidation cohortC-statisticPlasminogen activatorIntravenous tissue-type plasminogen activator treatmentRisk of sICHTissue-type plasminogen activator treatmentHigher baseline National InstitutesHigher systolic blood pressureDerivation sampleBaseline National InstitutesHealth Stroke ScaleStroke symptom onsetAcute ischemic strokeSystolic blood pressurePlasminogen activator treatmentMultivariable logistic regressionHigh blood glucoseNational Institute
2008
Off-Hour Admission and In-Hospital Stroke Case Fatality in the Get With The Guidelines-Stroke Program
Reeves M, Smith E, Fonarow G, Hernandez A, Pan W, Schwamm L. Off-Hour Admission and In-Hospital Stroke Case Fatality in the Get With The Guidelines-Stroke Program. Stroke 2008, 40: 569-576. PMID: 18988914, DOI: 10.1161/strokeaha.108.519355.Peer-Reviewed Original ResearchConceptsHemorrhagic stroke admissionsOff-hour presentationIschemic stroke admissionsQuality of careHospital case fatalityStroke admissionsHospital mortalityHours presentationCase fatalityIschemic strokeHospital case fatality rateGuidelines-Stroke programGWTG-Stroke programHospital-based outcomesAcute ischemic strokeHospital-level factorsStroke case fatalityTime of presentationCase fatality rateEquation logistic regressionQuality improvement effortsStroke ProgramAcute strokeHemorrhagic strokeHours admission