David Y Hwang, MD, FAAN (Neurology), FCCM, FNCS
Associate Professor AdjunctCards
Additional Titles
Staff Neurointensivist, Neuroscience Intensive Care Unit
Contact Info
About
Titles
Associate Professor Adjunct
Staff Neurointensivist, Neuroscience Intensive Care Unit
Biography
Dr. Hwang has been in the Division of Neurocritical Care and Emergency Neurology at the Yale School of Medicine and a neurointensivist at Yale-New Haven Hospital in Connecticut since 2012. His academic interests include how clinicians prognosticate outcome for severe acute brain injury patients, how surrogate decision making in Neuro ICUs can be improved, and how families of ICU patients can be best supported. He is a past recipient of the American Brain Foundation Practice Research Training Fellowship, the Neurocritical Care Society (NCS) Research Training Fellowship, the Robert G. Siekert New Investigator Award at the International Stroke Conference, the First-Place Patient and Family Support Abstract Award at the Society of Critical Care Medicine (SCCM) Critical Care Congress, and an Outstanding Oral Presentation Award at the NCS Research Conference. He is a recent Chair of the American Academy of Neurology Critical Care and Emergency Neurology Section, a member of the NCS Board of Directors, and a recent Chair of the SCCM Patient and Family Support Committee.
Appointments
Neurology
Associate Professor AdjunctPrimary
Other Departments & Organizations
- Neurology
- Stroke Telemedicine Program
- Yale Ventures
Education & Training
- Clinical and Research Fellow
- Massachusetts General Hospital / Brigham and Women's Hospital / Harvard Medical School (2012)
- Chief Resident
- Massachusetts General Hospital / Brigham and Women's Hospital / Harvard Medical School (2010)
- Resident
- Massachusetts General Hospital / Brigham and Women's Hospital / Harvard Medical School (2009)
- Intern
- Massachusetts General Hospital (2007)
- MD
- Harvard Medical School (2006)
- BS
- Emory University (2001)
Research
Overview
Medical Subject Headings (MeSH)
ORCID
0000-0002-2150-4289
Research at a Glance
Yale Co-Authors
Publications Timeline
Research Interests
Kevin Sheth, MD
Guido J. Falcone, MD, ScD, MPH
Charles Matouk, MD
Emily J. Gilmore, MD, FNCS, FACNS
Nils Petersen, MD/PhD, MSc
Rachel Beekman, MD
Intensive Care Units
Cerebral Hemorrhage
Decision Making
Family
Prognosis
Critical Illness
Publications
2024
Correction: Common Data Elements for Disorders of Consciousness: Recommendations from the Working Group on Goals-of-Care and Family/Surrogate Decision-Maker Data
Jaffa M, Kirsch H, Creutzfeldt C, Guanci M, Hwang D, LeTavec D, Mahanes D, Natarajan G, Steinberg A, Zahuranec D, Muehlschlegel S. Correction: Common Data Elements for Disorders of Consciousness: Recommendations from the Working Group on Goals-of-Care and Family/Surrogate Decision-Maker Data. Neurocritical Care 2024, 1-2. PMID: 39407076, DOI: 10.1007/s12028-024-02098-9.Peer-Reviewed Original ResearchGuidelines for Neuroprognostication in Critically Ill Adults with Moderate–Severe Traumatic Brain Injury
Muehlschlegel S, Rajajee V, Wartenberg K, Alexander S, Busl K, Creutzfeldt C, Fontaine G, Hocker S, Hwang D, Kim K, Madzar D, Mahanes D, Mainali S, Meixensberger J, Sakowitz O, Varelas P, Weimar C, Westermaier T. Guidelines for Neuroprognostication in Critically Ill Adults with Moderate–Severe Traumatic Brain Injury. Neurocritical Care 2024, 40: 448-476. PMID: 38366277, PMCID: PMC10959796, DOI: 10.1007/s12028-023-01902-2.Peer-Reviewed Original ResearchCitationsAltmetricConceptsTraumatic brain injuryBrain injuryFunctional outcomesSurrogate decision-makersSurrogates of patientsSystematic narrative reviewIMPACT lab modelQuality of evidenceClinical variablesDesirability of outcomesClinically relevant predictorsCritically ill adultsRecommendations AssessmentComfort measuresIn-hospital mortalityConclusionsThese guidelinesMsTBIEligibility criteriaPoor outcomeIll adultsPatient triagePractice recommendationsIndividual predictorsInternational Mission for PrognosisNarrative review
2023
Guidelines for neuroprognostication in adults with traumatic spinal cord injury
Mahanes D, Muehlschlegel S, Wartenberg K, Rajajee V, Alexander S, Busl K, Creutzfeldt C, Fontaine G, Hocker S, Hwang D, Kim K, Madzar D, Mainali S, Meixensberger J, Varelas P, Weimar C, Westermaier T, Sakowitz O. Guidelines for neuroprognostication in adults with traumatic spinal cord injury. Neurocritical Care 2023, 40: 415-437. PMID: 37957419, PMCID: PMC10959804, DOI: 10.1007/s12028-023-01845-8.Peer-Reviewed Original ResearchCitationsAltmetricConceptsSpinal cord injuryTraumatic spinal cord injuryCord injuryFunctional outcomeRecommendations AssessmentIndependent ambulationClinical variablesAmerican Spinal Injury Association (ASIA) Impairment Scale (AIS) grade conversionBest practice recommendationsPractice recommendationsReliable predictorCandidate clinical variablesPatient-centered prioritiesClinical prediction ruleQuality of evidenceLow-quality studiesGuideline development processAbility of cliniciansSeverity of injuryLong-term qualityFull-text reviewMagnetic resonance imagingTime of assessmentNarrative systematic reviewConclusionsThese guidelinesGuidelines for Neuroprognostication in Critically Ill Adults with Intracerebral Hemorrhage
Hwang D, Kim K, Muehlschlegel S, Wartenberg K, Rajajee V, Alexander S, Busl K, Creutzfeldt C, Fontaine G, Hocker S, Madzar D, Mahanes D, Mainali S, Sakowitz O, Varelas P, Weimar C, Westermaier T, Meixensberger J. Guidelines for Neuroprognostication in Critically Ill Adults with Intracerebral Hemorrhage. Neurocritical Care 2023, 40: 395-414. PMID: 37923968, PMCID: PMC10959839, DOI: 10.1007/s12028-023-01854-7.Peer-Reviewed Original ResearchCitationsAltmetricConceptsClinical grading scaleClinical variablesGrading scaleRecommendations AssessmentPoor outcomeIntensive care unit admissionCandidate clinical variablesCritically Ill AdultsIndividual clinical variablesMajor clinical predictorsCare unit admissionCounseling of patientsBest practice statementsJudgment of prognosisNarrative systematic reviewConclusionsThese guidelinesUnit admissionNeurological recoveryClinical predictorsIll adultsCounseling patientsIntracerebral hemorrhageFunctional outcomeConsensus statementNeuroprognosticationSporadic Creutzfeldt-Jakob Disease Initially Presenting With Posterior Reversible Encephalopathy Syndrome
Mikhaiel J, Parasram M, Manning T, Al-Dulaimi M, Barnes E, Falcone G, Hwang D, Prust M. Sporadic Creutzfeldt-Jakob Disease Initially Presenting With Posterior Reversible Encephalopathy Syndrome. The Neurologist 2023, 29: 14-16. PMID: 37582680, DOI: 10.1097/nrl.0000000000000519.Peer-Reviewed Original ResearchAltmetricMeSH Keywords and ConceptsConceptsSporadic Creutzfeldt-Jakob diseaseMagnetic resonance imagingReversible encephalopathy syndromeCreutzfeldt-Jakob diseaseEncephalopathy syndromeAntiseizure medicationsLumbar punctureDiagnosis of sCJDFluid-attenuated inversion recovery changesPosterior reversible encephalopathy syndromeRepeat magnetic resonance imagingCases of sCJDPeriodic dischargesMultiple antiseizure medicationsRepeat lumbar punctureStuporous mental stateInitial lumbar punctureInversion recovery hyperintensityNonconvulsive status epilepticusReal-time quaking-induced conversionFatal neurodegenerative conditionProgressive confusionRadiographic improvementNeurological declineStatus epilepticusEmergent external ventricular drain placement in patients with factor Xa inhibitor-associated intracerebral hemorrhage after reversal with andexanet alfa
Ammar A, Elsamadicy A, Ammar M, Reeves B, Koo A, Falcone G, Hwang D, Petersen N, Kim J, Beekman R, Prust M, Magid-Bernstein J, Acosta J, Herbert R, Sheth K, Matouk C, Gilmore E. Emergent external ventricular drain placement in patients with factor Xa inhibitor-associated intracerebral hemorrhage after reversal with andexanet alfa. Clinical Neurology And Neurosurgery 2023, 226: 107621. PMID: 36791588, DOI: 10.1016/j.clineuro.2023.107621.Peer-Reviewed Original ResearchCitationsMeSH Keywords and ConceptsConceptsAndexanet alfaExtra-axial hemorrhageEVD placementThrombotic eventsNew hemorrhagePrimary safety outcomeExternal ventricular drain placementLarge prospective studiesIntensive care unitIntracerebral hemorrhage patientsVentricular drain placementBolus patientsHospital lengthHospital LOSICU LOSTract hemorrhageRankin scoreSecondary outcomesAdult patientsBolus groupPrimary outcomeCare unitIntracerebral hemorrhageLong administration timeHemorrhage patientsImplementation of a Standardized Shared Decision-making Bundle to Improve Communication Practices in the Neurocritical Care Unit
Waseem H, Keegan J, Farrell K, Hwang D, Oliver B, Olm-Shipman C, Pepin R, Mecchella J. Implementation of a Standardized Shared Decision-making Bundle to Improve Communication Practices in the Neurocritical Care Unit. Neurology Clinical Practice 2023, 13: e200120. PMID: 36865641, PMCID: PMC9973293, DOI: 10.1212/cpj.0000000000200120.Peer-Reviewed Original ResearchCitationsAltmetricConceptsShared decision-makingSDM conversationsNeurocritical care unitInstitute for Healthcare Improvement's ModelHealth care team membersPlan-Do-Study-Act cyclesPlan-Do-Study-ActCare team membersQuality improvement initiativesElectronic medical recordsPrimary outcome measureInterprofessional teamConsultation ratesSDM practicesIdentified barriersImproved documentationImprovement initiativesLength of stayPatient's familyTeam workflowImprove communicationOutcome measuresPatient preferencesFamily goalsDocumentation tools
2022
Pilot Randomized Clinical Trial of a Goals-of-Care Decision Aid for Surrogates of Patients With Severe Acute Brain Injury
Muehlschlegel S, Goostrey K, Flahive J, Zhang Q, Pach JJ, Hwang DY. Pilot Randomized Clinical Trial of a Goals-of-Care Decision Aid for Surrogates of Patients With Severe Acute Brain Injury. Neurology 2022, 99: e1446-e1455. PMID: 35853748, PMCID: PMC9576301, DOI: 10.1212/wnl.0000000000200937.Peer-Reviewed Original ResearchCitationsAltmetricMeSH Keywords and ConceptsConceptsCode status changeTraumatic brain injuryBrain injuryIschemic strokeCare decisionsIntracerebral hemorrhageDA groupAcute brain injury patientsSevere acute brain injuryNeurologic intensive care unitCare decision aidSurrogates of patientsAcute brain injuryAcute ischemic strokeClass IV evidenceLong-term prognosisIntensive care unitBrain injury patientsClinician-family communicationAdditional psychosocial supportPatient-centered careLife-sustaining treatmentPsychological outcomesDecision-making interventionClassification of evidencePsychological Attachment Orientation and Long-Term Posttraumatic Stress Symptoms Among Family Members of ICU Patients
Zhang Q, Knies AK, Pach J, Kimbrough T, Martinez A, Juthani P, Tu S, Monin JK, Vranceanu AM, Hwang DY. Psychological Attachment Orientation and Long-Term Posttraumatic Stress Symptoms Among Family Members of ICU Patients. Critical Care Explorations 2022, 4: e0753. PMID: 36050994, PMCID: PMC9426807, DOI: 10.1097/cce.0000000000000753.Peer-Reviewed Original ResearchCitationsAltmetricConceptsICU patientsPTSD symptomsICU dischargeHispanic ethnicityFamily meetingsFamily membersICU patients' family membersProspective cohort studyMultiple logistic regressionLong-term PTSD symptomsPatients' family membersHigh-risk categoryLonger-term posttraumatic stress symptomsPosttraumatic stress disorder (PTSD) symptomsNeuroscience ICUEvent Scale-RevisedCohort studyIndependent predictorsPatient characteristicsRisk factorsPatient deathUnivariate analysisPatient covariatesSignificant symptomsPsychologic outcomesCoping Strategies and Psychosocial Resource Needs Reported by Families of Patients Recovering from Coma in Neurointensive Care Units: Preliminary Findings from a Multicenter Qualitative Study (RP423)
Kubota R, Meurer K, Baskaran N, Zhang Q, Bannon S, Fishbein N, Lichstein K, Reichman M, Popok P, Lester E, Motta M, Muehlschlegel S, Reznik M, Jaffa M, Creutzfeldt C, Fehnel C, Freeman W, Williamson C, Vranceanu A, Hwang D. Coping Strategies and Psychosocial Resource Needs Reported by Families of Patients Recovering from Coma in Neurointensive Care Units: Preliminary Findings from a Multicenter Qualitative Study (RP423). Journal Of Pain And Symptom Management 2022, 63: 1095-1096. DOI: 10.1016/j.jpainsymman.2022.04.064.Peer-Reviewed Original ResearchCitationsAltmetricConceptsCommon coping strategiesCoping strategiesSevere acute brain injuryPsychosocial resourcesSABI patientsFamily caregiversPsychosocial supportAcute brain injuryNeurointensive care unitFamily support interventionBrain injuryPositive emotionsCare unitPsychological distressYears of collegeSocial supportPersonal social networksGlasgow Coma Scale scorePrimary caregiversTeam membersPrior experienceEffective interventionsInterview transcriptsFamilies of patientsMulticenter qualitative study
Clinical Trials
Current Trials
Transforming Acute Stroke Detection through Real Time Neurological Monitoring
HIC ID1605017863RoleSub InvestigatorPrimary Completion Date07/01/2017Recruiting ParticipantsGenderBothAge18+ years
Academic Achievements & Community Involvement
activity Society of Critical Care Medicine
Professional OrganizationsMemberDetails2012 - Presentactivity American Stroke Association
Professional OrganizationsMemberDetails08/20/2012 - Presentactivity Neurocritical Care Society
Professional OrganizationsMemberDetails07/01/2011 - Presentactivity American Academy of Neurology
Professional OrganizationsMemberDetails07/01/2007 - Presentactivity American Neurological Association
Professional OrganizationsMemberDetails07/01/2014 - Present
News
News
- May 13, 2021
AAN 2021 Virtual Annual Meeting: Highlights
- February 03, 2021Source: NeurologyToday
Dexamethasone Gets Low Marks for Chronic Subdural Hematoma
- January 24, 2021Source: Relias Media
Palliative Care Encounters Ethical Conflicts: Consistent Communication Is Key
- November 01, 2020Source: Medical Ethics Advisor
Growing Movement Toward More Family Participation in ICUs