2019
The Medicare Shared Savings Program and Outcomes for Ischemic Stroke Patients: a Retrospective Cohort Study
Kaufman B, O’Brien E, Stearns S, Matsouaka R, Holmes G, Weinberger M, Song P, Schwamm L, Smith E, Fonarow G, Xian Y. The Medicare Shared Savings Program and Outcomes for Ischemic Stroke Patients: a Retrospective Cohort Study. Journal Of General Internal Medicine 2019, 34: 2740-2748. PMID: 31452032, PMCID: PMC6854149, DOI: 10.1007/s11606-019-05283-1.Peer-Reviewed Original ResearchConceptsAccountable care organizationsIschemic strokeRecurrent strokeMSSP accountable care organizationsIndex hospital stayIncident ischemic strokeRetrospective cohort studyAcute care utilizationIschemic stroke patientsMedicare Shared Savings Program Accountable Care OrganizationsModerate ischemic strokeConclusionsAmong patientsMain MeasuresOutcomesCause readmissionHospital stayCohort studyHome dischargeCare utilizationStroke patientsTransitional careProbability of dischargeCare coordinationPatient outcomesMedicare claimsService beneficiaries
2018
Implementation of a Rapid, Protocol-based TIA Management Pathway
Jarhult S, Howell M, Barnaure-Nachbar I, Chang Y, White B, Amatangelo M, Brown D, Singhal A, Schwamm L, Silverman S, Goldstein J. Implementation of a Rapid, Protocol-based TIA Management Pathway. Western Journal Of Emergency Medicine 2018, 19: 216-223. PMID: 29560046, PMCID: PMC5851491, DOI: 10.5811/westjem.2017.9.35341.Peer-Reviewed Original ResearchMeSH KeywordsAgedClinical ProtocolsEmergency Service, HospitalFemaleHumansIschemic Attack, TransientLength of StayMaleNeuroimagingConceptsTransient ischemic attackTotal hospital LOSHospital LOSEmergency departmentED LOSFinal diagnosisRecurrent transient ischemic attacksTertiary care academic centerED observation unitIntermediate-risk patientsHigh-risk patientsProportion of patientsMedian ED LOSInpatient admission ratesNeck CT angiographyBrain magnetic resonanceNeck MR angiographyStandardized clinical protocolUse of neuroimagingIschemic attackCohort studyTIA symptomsConsecutive patientsED lengthSix-month period
2017
Healthcare 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
2015
Association 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 ratioHyperglycemiaLack of Impact of Electronic Health Records on Quality of Care and Outcomes for Ischemic Stroke
Joynt K, Bhatt D, Schwamm L, Xian Y, Heidenreich P, Fonarow G, Smith E, Neely M, Grau-Sepulveda M, Hernandez A. Lack of Impact of Electronic Health Records on Quality of Care and Outcomes for Ischemic Stroke. Journal Of The American College Of Cardiology 2015, 65: 1964-1972. PMID: 25953748, DOI: 10.1016/j.jacc.2015.02.059.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overElectronic Health RecordsFemaleHospital Bed CapacityHospital MortalityHospitals, TeachingHumansLength of StayMaleMiddle AgedOutcome Assessment, Health CarePatient DischargePractice Guidelines as TopicQuality of Health CareStrokeTime-to-TreatmentTissue Plasminogen ActivatorUnited StatesConceptsElectronic health recordsIschemic strokeGWTG-Stroke hospitalsHealth recordsBetter clinical outcomesLogistic regression analysisAmerican Hospital Association Annual SurveyQuality of careOutcomes of interestHigh-quality careGuidelines-StrokeHospital mortalityStroke centersClinical outcomesStroke careSimilar oddsHospital characteristicsOutcome measuresTimely careHospitalPatientsStudy periodCareU.S. hospitalsStrokeContemporary Trends and Predictors of Postacute Service Use and Routine Discharge Home After Stroke
Bettger J, McCoy L, Smith E, Fonarow G, Schwamm L, Peterson E. Contemporary Trends and Predictors of Postacute Service Use and Routine Discharge Home After Stroke. Journal Of The American Heart Association 2015, 4: e001038. PMID: 25713291, PMCID: PMC4345857, DOI: 10.1161/jaha.114.001038.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overBrain IschemiaFemaleHome Health NursingHospitalizationHumansIntracranial HemorrhagesLength of StayMaleMiddle AgedMultivariate AnalysisPatient DischargeRecovery of FunctionRehabilitation CentersRisk FactorsSelf CareSkilled Nursing FacilitiesStrokeStroke RehabilitationTreatment OutcomeWalkingConceptsInpatient rehabilitation facilityPAC useSkilled nursing facilitiesHome healthStroke patientsService useHealth insurance typeHospital discharge dispositionStrongest clinical predictorsYears of agePostacute care servicesGuidelines-StrokeDischarge homeHospital stayDischarge dispositionClinical predictorsHemorrhagic strokeOral intakeDysphagia screenMultivariable analysisAcute careStroke hospitalizationsInsurance typeSNF useNursing facilities
2014
Impact of centralising acute stroke services in English metropolitan areas on mortality and length of hospital stay: difference-in-differences analysis
Morris S, Hunter R, Ramsay A, Boaden R, McKevitt C, Perry C, Pursani N, Rudd A, Schwamm L, Turner S, Tyrrell P, Wolfe C, Fulop N. Impact of centralising acute stroke services in English metropolitan areas on mortality and length of hospital stay: difference-in-differences analysis. The BMJ 2014, 349: g4757. PMID: 25098169, PMCID: PMC4122734, DOI: 10.1136/bmj.g4757.Peer-Reviewed Original ResearchMeSH KeywordsAgedEnglandFemaleFollow-Up StudiesHumansLength of StayLogistic ModelsMaleRisk AdjustmentStrokeUrban Health ServicesConceptsAcute stroke servicesAcute stroke careHospital stayHyperacute careStroke servicesStroke careHospital Episode Statistics databaseSymptoms of strokePatient-level dataSignificant declineIschemic strokeHospital admissionStayPatientsAbsolute reductionMortalityStrokeMortality dataCareStatistics databaseMonth periodGreater ManchesterAdmissionDaysRisk
2013
Hospital Acquired Pneumonia Is Linked to Right Hemispheric Peri-Insular Stroke
Kemmling A, Lev MH, Payabvash S, Betensky RA, Qian J, Masrur S, Schwamm LH. Hospital Acquired Pneumonia Is Linked to Right Hemispheric Peri-Insular Stroke. PLOS ONE 2013, 8: e71141. PMID: 23951094, PMCID: PMC3737185, DOI: 10.1371/journal.pone.0071141.Peer-Reviewed Original ResearchConceptsHemispheric infarctsBrain regionsConsecutive acute stroke patientsConditional logistic regression modelsHospital-Acquired PneumoniaRight hemispheric infarctAcute stroke patientsInsular cortex volumeVolume-based variablesSpecific brain regionsLogistic regression modelsAcquired PneumoniaControl patientsMajor complicationsBrainstem strokeImmune suppressionInfarct sizeStroke patientsAutonomic modulationClinical variablesAdmission imagingInfarct locationUnivariate analysisImmune mechanismsCortex volume
2011
Representativeness of the Get With The Guidelines–Stroke Registry
Reeves M, Fonarow G, Smith E, Pan W, Olson D, Hernandez A, Peterson E, Schwamm L. Representativeness of the Get With The Guidelines–Stroke Registry. Stroke 2011, 43: 44-49. PMID: 21980197, DOI: 10.1161/strokeaha.111.626978.Peer-Reviewed Original ResearchConceptsIschemic stroke admissionsGWTG-Stroke hospitalsGWTG-StrokeMedicare cohortStroke admissionsStroke hospitalsIschemic strokePatient characteristicsMedicare patientsGuidelines-Stroke registryGWTG-Stroke programIschemic stroke populationService Medicare patientsAcute ischemic strokeLength of stayHospital mortalityDischarge homeHospital outcomesAcute strokeStroke populationHospital characteristicsMedicare beneficiariesAdmissionHospitalNational feePredictors of Hospital Length of Stay in Heart Failure: Findings from Get With the Guidelines
Whellan D, Zhao X, Hernandez A, Liang L, Peterson E, Bhatt D, Heidenreich P, Schwamm L, Fonarow G. Predictors of Hospital Length of Stay in Heart Failure: Findings from Get With the Guidelines. Journal Of Cardiac Failure 2011, 17: 649-656. PMID: 21807326, DOI: 10.1016/j.cardfail.2011.04.005.Peer-Reviewed Original ResearchConceptsStandard laboratory evaluationBrain natriuretic peptideHospital characteristicsPatient characteristicsMore comorbiditiesHospital lengthLonger LOSGuidelines-Heart FailureAdmission vital signsHeart failure patientsTime of admissionBNP levelsHF patientsFailure patientsHeart failureNatriuretic peptideClinical variablesPatient admissionsPatientsDisease severityVital signsHigher disease severityAdmissionLOS variationAdmission predictors
2010
Characteristics, Performance Measures, and In-Hospital Outcomes of the First One Million Stroke and Transient Ischemic Attack Admissions in Get With The Guidelines-Stroke
Fonarow G, Reeves M, Smith E, Saver J, Zhao X, Olson D, Hernandez A, Peterson E, Schwamm L. Characteristics, Performance Measures, and In-Hospital Outcomes of the First One Million Stroke and Transient Ischemic Attack Admissions in Get With The Guidelines-Stroke. Circulation Cardiovascular Quality And Outcomes 2010, 3: 291-302. PMID: 20177051, DOI: 10.1161/circoutcomes.109.921858.Peer-Reviewed Original ResearchConceptsHospital mortality rateIntracerebral hemorrhageQuality of careIschemic strokeSubarachnoid hemorrhageMortality rateTransient ischemic attack admissionsTransient ischemic attack patientsIn-Hospital OutcomesAcute ischemic strokeIschemic stroke patientsAdjusted odds ratioLength of stayQuality improvement effortsGuidelines-StrokeGWTG-StrokeTIA admissionsTIA careTIA patientsHospital outcomesAcute strokeStroke patientsMean ageAttack patientsNational surveillance