2024
Twenty Years of Sustained Improvement in Quality of Care and Outcomes for Patients Hospitalized With Stroke or Transient Ischemic Attack: Data From The Get With The Guidelines-Stroke Program
Xian Y, Li S, Jiang T, Beon C, Poudel R, Thomas K, Reeves M, Smith E, Saver J, Sheth K, Messé S, Schwamm L, Fonarow G. Twenty Years of Sustained Improvement in Quality of Care and Outcomes for Patients Hospitalized With Stroke or Transient Ischemic Attack: Data From The Get With The Guidelines-Stroke Program. Stroke 2024, 55: 2599-2610. PMID: 39429153, PMCID: PMC11518659, DOI: 10.1161/strokeaha.124.048174.Peer-Reviewed Original ResearchConceptsGuidelines-Stroke programEvidence-based stroke careDoor-to-needle timeTransient ischemic attackGuidelines-Stroke hospitalsEvidence-based careQuality of careSmoking cessation counselingSustained improvementQuality improvement initiativesSkilled nursing facilityIndependence of patientsAcute ischemic strokeIschemic strokeRelevant to patientsIschemic attackDoor-to-puncture timeCessation counselingGuidelines-StrokeAssociated with sustained improvementStroke careDysphagia screeningNursing facilitiesHospital characteristicsImprovement initiatives
2022
Frequency, predictors and cardiovascular outcomes associated with transthoracic echocardiographic findings during acute ischaemic stroke hospitalisation
Sharma R, Silverman S, Patel S, Schwamm LH, Sanborn DY. Frequency, predictors and cardiovascular outcomes associated with transthoracic echocardiographic findings during acute ischaemic stroke hospitalisation. Stroke And Vascular Neurology 2022, 7: 482-492. PMID: 35697387, PMCID: PMC9811598, DOI: 10.1136/svn-2021-001170.Peer-Reviewed Original ResearchConceptsStroke risk factorsAcute ischemic strokeStroke hospitalisationsTransthoracic echocardiographyRisk factorsClinical utilityAbnormal transthoracic echocardiographyHigh stroke riskCardiac event riskCoronary artery diseaseTransthoracic echocardiographic findingsNet reclassification improvementCategory ICardioembolic sourceRecurrent strokeTTE findingsCardiovascular outcomesEchocardiographic findingsCardiac eventsIschemic strokeOlder patientsStroke riskArtery diseaseSingle centerAtrial fibrillationInfluence of Hospital Characteristics on Hospital Transfer Destinations for Patients With Stroke
Zachrison K, Amati V, Schwamm L, Yan Z, Nielsen V, Christie A, Reeves M, Sauser J, Lomi A, Onnela J. Influence of Hospital Characteristics on Hospital Transfer Destinations for Patients With Stroke. Circulation Cardiovascular Quality And Outcomes 2022, 15: e008269. PMID: 35369714, DOI: 10.1161/circoutcomes.121.008269.Peer-Reviewed Original Research
2021
Integration of Regional Hospitalizations, Registry and Vital Statistics Data for Development of a Single Statewide Ischemic Stroke Database
Yan Z, Nielsen V, Song G, Christie A, Schwamm L, Zachrison K. Integration of Regional Hospitalizations, Registry and Vital Statistics Data for Development of a Single Statewide Ischemic Stroke Database. Journal Of Stroke And Cerebrovascular Diseases 2021, 31: 106236. PMID: 34954597, DOI: 10.1016/j.jstrokecerebrovasdis.2021.106236.Peer-Reviewed Original ResearchMeSH KeywordsDatabases, FactualHospitalizationHumansIschemic StrokeMassachusettsRegistriesVital StatisticsConceptsStroke databaseDetailed clinical variablesPopulation-based studyLong-term outcomesIndirect identifiersVital statistics databaseHospitalization registryStroke admissionsHospitalization databaseVital statistics dataTerm outcomesVital statusClinical variablesLarge-scale outcome researchClinical registryHospitalization recordsPatient variablesAdministrative databasesClinical dataRich clinical dataRegistryHospitalizationDeterministic linkageCumulative mortalityVital recordsAssociation 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 outcomesUsefulness of Rhythm Monitoring Following Acute Ischemic Stroke
Khurshid S, Li X, Ashburner J, Lipsanopoulos A, Lee P, Lin A, Ko D, Ellinor P, Schwamm L, Benjamin E, Atlas S, Singer D, Anderson C, Trinquart L, Lubitz S. Usefulness of Rhythm Monitoring Following Acute Ischemic Stroke. The American Journal Of Cardiology 2021, 147: 44-51. PMID: 33617814, DOI: 10.1016/j.amjcard.2021.01.038.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeIschemic strokeCryptogenic strokeCause-specific hazards regressionCHARGE-AF scoreAtrial fibrillation riskRisk of deathFine-Gray modelCHARGE-AFIncident AFPrevalent AFDischarge dispositionStroke subtypesConsecutive patientsAF riskHazards regressionStroke survivorsAssessed associationsRhythm monitoringStrokeAF scorePatientsIncidenceOne-thirdRisk
2020
Trends in Reperfusion Therapy for In-Hospital Ischemic Stroke in the Endovascular Therapy Era
Akbik F, Xu H, Xian Y, Shah S, Smith E, Bhatt D, Matsouaka R, Fonarow G, Schwamm L. Trends in Reperfusion Therapy for In-Hospital Ischemic Stroke in the Endovascular Therapy Era. JAMA Neurology 2020, 77: 1486-1495. PMID: 32955582, PMCID: PMC7506601, DOI: 10.1001/jamaneurol.2020.3362.Peer-Reviewed Original ResearchConceptsHospital stroke onsetHospital onsetIntravenous thrombolysisStroke onsetEndovascular therapyReperfusion therapyHospital strokeCohort studyIschemic strokeFunctional outcomeNational registryIn-Hospital Ischemic StrokeIntravenous thrombolysis treatmentLimited contemporary dataRetrospective cohort studyAcute ischemic strokeVascular risk factorsWorse functional outcomeEndovascular reperfusion therapyLonger median timeKey patient characteristicsTherapy eraThrombolysis treatmentHospital dischargePatient characteristicsLeft Atrial Mechanics Assessed Early during Hospitalization for Cryptogenic Stroke Are Associated with Occult Atrial Fibrillation: A Speckle-Tracking Strain Echocardiography Study
Deferm S, Bertrand PB, Churchill TW, Sharma R, Vandervoort PM, Schwamm LH, Yoerger Sanborn DM. Left Atrial Mechanics Assessed Early during Hospitalization for Cryptogenic Stroke Are Associated with Occult Atrial Fibrillation: A Speckle-Tracking Strain Echocardiography Study. Journal Of The American Society Of Echocardiography 2020, 34: 156-165. PMID: 33132019, DOI: 10.1016/j.echo.2020.09.009.Peer-Reviewed Original ResearchMeSH KeywordsAtrial FibrillationEchocardiographyHeart AtriaHospitalizationHumansIschemic StrokeRetrospective StudiesStrokeConceptsMobile cardiac outpatient telemetryOccult atrial fibrillationBooster pump functionAtrial fibrillationCryptogenic strokeAtrial mechanicsStrain echocardiographyReservoir strainPump functionBaseline cardiovascular risk profileLA booster pump functionPresence of AFCardiovascular risk profileLA volume indexReceiver operator curve analysisOperator curve analysisSpontaneous cardioversionEmbolic strokeClinical characteristicsRetrospective cohortEchocardiography studyLA sizeMedian timeStroke hospitalizationsEchocardiography
2018
Participation in Get With the Guidelines–Stroke and Its Association With Quality of Care for Stroke
Howard G, Schwamm LH, Donnelly JP, Howard VJ, Jasne A, Smith EE, Rhodes JD, Kissela BM, Fonarow GC, Kleindorfer DO, Albright KC. Participation in Get With the Guidelines–Stroke and Its Association With Quality of Care for Stroke. JAMA Neurology 2018, 75: 1331-1337. PMID: 30083763, PMCID: PMC6248106, DOI: 10.1001/jamaneurol.2018.2101.Peer-Reviewed Original ResearchConceptsTissue plasminogen activatorIschemic strokeQuality of careGuidelines-StrokeGWTG-StrokeMean ageNonparticipating hospitalsCare measuresRisk factorsPopulation-based cohort studyPlasminogen activatorLipid profile assessmentParticipants 45 yearsStroke risk factorsQuality Improvement ProgramEvidence-based interventionsExercise counselingNeurologist evaluationAntithrombotic therapyCohort studyAntithrombotic useStroke careMAIN OUTCOMELipid evaluationHospitalIncidence 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 ControlsPatientsQuality of care for ischemic stroke in China vs India: Findings from national clinical registries.
Li Z, Pandian J, Sylaja P, Wang Y, Zhao X, Liu L, Wang C, Khurana D, Srivastava M, Kaul S, Arora D, Schwamm L, Wang Y, Singhal A. Quality of care for ischemic stroke in China vs India: Findings from national clinical registries. Neurology 2018, 91: e1348-e1354. PMID: 30158158, PMCID: PMC6177271, DOI: 10.1212/wnl.0000000000006291.Peer-Reviewed Original ResearchConceptsChina National Stroke Registry IIGreater stroke severityStroke risk factorsRisk factorsStroke severityClinical outcomesStroke careIndian patientsAcademic stroke centerNational clinical registryIschemic stroke patientsBurden of strokeIschemic stroke careDifferent risk factorsQuality of careHospital mortalityIschemic strokeStroke centersAcute managementStroke patientsStroke ProjectChinese patientsClinical registryWorse outcomesAcademic hospital
2017
Response by Boulouis and Schwamm to Letter Regarding Article, “Immediate Vascular Imaging Needed for Efficient Triage of Patients With Acute Ischemic Stroke Initially Admitted to Nonthrombectomy Centers”
Boulouis G, Schwamm L. Response by Boulouis and Schwamm to Letter Regarding Article, “Immediate Vascular Imaging Needed for Efficient Triage of Patients With Acute Ischemic Stroke Initially Admitted to Nonthrombectomy Centers”. Stroke 2017, 48: e327-e328. PMID: 28954918, DOI: 10.1161/strokeaha.117.018964.Peer-Reviewed Original ResearchUnexplained Variation for Hospitals’ Use of Inpatient Rehabilitation and Skilled Nursing Facilities After an Acute Ischemic Stroke
Xian Y, Thomas L, Liang L, Federspiel J, Webb L, Bushnell C, Duncan P, Schwamm L, Stein J, Fonarow G, Hoenig H, Montalvo C, George M, Lutz B, Peterson E, Bettger J. Unexplained Variation for Hospitals’ Use of Inpatient Rehabilitation and Skilled Nursing Facilities After an Acute Ischemic Stroke. Stroke 2017, 48: 2836-2842. PMID: 28830975, DOI: 10.1161/strokeaha.117.016904.Peer-Reviewed Original ResearchConceptsInpatient rehabilitation facilitySkilled nursing facilitiesAcute ischemic strokeHospital-level variationIschemic strokeNursing facilitiesGuidelines-Stroke hospitalsMultilevel logistic regression modelsMedian odds ratioGeographic availabilityLogistic regression modelsIRF patientsHospital complicationsSNF patientsClinical characteristicsComorbid conditionsInpatient rehabilitationHospital characteristicsClinical registryOdds ratioRehabilitation facilityHospital useMedicare beneficiariesPatientsHospitalBlood pressure and in-hospital outcomes in patients presenting with ischaemic stroke
Bangalore S, Schwamm L, Smith E, Hellkamp A, Suter R, Xian Y, Schulte P, Fonarow G, Bhatt D, Committee and Investigators F. Blood pressure and in-hospital outcomes in patients presenting with ischaemic stroke. European Heart Journal 2017, 38: 2827-2835. PMID: 28982227, PMCID: PMC5837595, DOI: 10.1093/eurheartj/ehx330.Peer-Reviewed Original ResearchConceptsMean arterial pressureSystolic blood pressureAcute ischemic strokeDiastolic blood pressureBlood pressureIschemic strokeShort-term outcomesHaemorrhagic complicationsThrombolytic therapyPulse pressureHospital outcomesAdmission diastolic blood pressureHigher systolic BP valuesPoor short-term outcomeHigher systolic blood pressureLower systolic blood pressureGuidelines-Stroke registryPost-stroke hypertensionLower blood pressureSystolic BP valuesOutcomes of interestAdmission systolicHospital mortalityHospital deathArterial pressure
2016
Sex and Age Interactions and Differences in Outcomes After Intracerebral Hemorrhage
James M, Cox M, Xian Y, Smith E, Bhatt D, Schulte P, Hernandez A, Fonarow G, Schwamm L. Sex and Age Interactions and Differences in Outcomes After Intracerebral Hemorrhage. Journal Of Women's Health 2016, 26: 380-388. PMID: 27754758, DOI: 10.1089/jwh.2016.5849.Peer-Reviewed Original ResearchConceptsIntracerebral hemorrhageSex-based interactionsTotal study populationWorse neurological deficitsAge/sexSex differencesAntiplatelet therapyHospital mortalityIschemic strokeNeurological deficitsPatient ageIndependent ambulationICH patientsStroke databaseAtrial fibrillationEarly outcomesPoor outcomeStudy populationCholesterol reducersLogistic regressionWomenTreatment differencesAgeMenHemorrhageAdmitting the Patient With Acute Stroke to the Right House—Lessons From the Sorting Hat of Hogwarts
Schwamm L. Admitting the Patient With Acute Stroke to the Right House—Lessons From the Sorting Hat of Hogwarts. JAMA Internal Medicine 2016, 176: 1368-70. PMID: 27454422, DOI: 10.1001/jamainternmed.2016.3930.Peer-Reviewed Original ResearchSex 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 minoritiesAssociation of Get With The Guidelines-Stroke Program Participation and Clinical Outcomes for Medicare Beneficiaries With Ischemic Stroke
Song S, Fonarow G, Olson D, Liang L, Schulte P, Hernandez A, Peterson E, Reeves M, Smith E, Schwamm L, Saver J. Association of Get With The Guidelines-Stroke Program Participation and Clinical Outcomes for Medicare Beneficiaries With Ischemic Stroke. Stroke 2016, 47: 1294-1302. PMID: 27079809, PMCID: PMC4975426, DOI: 10.1161/strokeaha.115.011874.Peer-Reviewed Original ResearchConceptsAcute ischemic stroke admissionsGWTG-Stroke programIschemic stroke admissionsClinical outcomesStroke admissionsMedicare beneficiariesAcute care US hospitalsHospital-based quality improvement programsGWTG-Stroke hospitalsImproved functional outcomesAmerican Heart AssociationQuality Improvement ProgramGWTG-StrokePostdischarge mortalityAcute strokeIschemic strokeFunctional outcomeHeart AssociationNonparticipating hospitalsStroke hospitalsHospital participationUS hospitalsHospitalPre periodSimilar hospitals
2015
Increased Risk of Cerebrovascular Disease Among Patients With Neurofibromatosis Type 1
Terry A, Jordan J, Schwamm L, Plotkin S. Increased Risk of Cerebrovascular Disease Among Patients With Neurofibromatosis Type 1. Stroke 2015, 47: 60-65. PMID: 26645253, DOI: 10.1161/strokeaha.115.011406.Peer-Reviewed Original ResearchConceptsNeurofibromatosis type 1Ischemic strokeIntracerebral hemorrhageGeneral populationCases of NF1US Nationwide Inpatient SampleType 1Hemorrhagic stroke typesNew neurological symptomsStroke risk factorsRisk of strokeOdds of strokeTime of strokeNationwide Inpatient SampleMultivariable logistic regressionCase-control studyType of strokeYounger mean ageAdult patientsPediatric patientsHemorrhagic strokeNeurological symptomsCerebrovascular diseaseMean ageInpatient SampleQuality of Care and Ischemic Stroke Risk After Hospitalization for Transient Ischemic Attack
O'Brien E, Zhao X, Fonarow G, Schulte P, Dai D, Smith E, Schwamm L, Bhatt D, Xian Y, Saver J, Reeves M, Peterson E, Hernandez A. Quality of Care and Ischemic Stroke Risk After Hospitalization for Transient Ischemic Attack. Circulation Cardiovascular Quality And Outcomes 2015, 8: s117-s124. PMID: 26515199, DOI: 10.1161/circoutcomes.115.002048.Peer-Reviewed Original ResearchConceptsTransient ischemic attackDefect-free careIschemic strokeIschemic stroke riskQuality of careIschemic attackStroke riskCare measuresRisk scoreOverall hospital admission rateRisk score quintilesYear post dischargeLow-risk patientsHospital admission ratesIschemic stroke admissionsPrevious myocardial infarctionAbsence of strokeMedicare inpatient claimsCox proportional hazardsModerate discriminative performanceTIA patientsCause mortalityCessation counselingStroke admissionsBaseline demographics