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 ResearchSpinal 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 ResearchClinical 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 statementNeuroprognostication
2022
Effect of Early vs Standard Approach to Tracheostomy on Functional Outcome at 6 Months Among Patients With Severe Stroke Receiving Mechanical Ventilation
Bösel J, Niesen WD, Salih F, Morris NA, Ragland JT, Gough B, Schneider H, Neumann JO, Hwang DY, Kantamneni P, James ML, Freeman WD, Rajajee V, Rao CV, Nair D, Benner L, Meis J, Klose C, Kieser M, Suarez JI, Schönenberger S, Seder DB, Ramadan A, Claassen J, Mayer S, Peled H, Christianson T, May T, Riker R, Asgarpur G, Stetefeld H, Kluge S. Effect of Early vs Standard Approach to Tracheostomy on Functional Outcome at 6 Months Among Patients With Severe Stroke Receiving Mechanical Ventilation. JAMA 2022, 327: 1899-1909. PMID: 35506515, PMCID: PMC9069344, DOI: 10.1001/jama.2022.4798.Peer-Reviewed Original ResearchConceptsEarly tracheostomy groupEarly tracheostomyMechanical ventilationSevere strokeFunctional outcomeStandard tracheostomyTracheostomy groupPrimary outcomeControl groupProlonged invasive mechanical ventilationModified Rankin Scale scoreSevere disabilityInvasive mechanical ventilationSerious adverse eventsRankin Scale scoreAirway protective reflexesRate of survivalInvasive ventilationAdverse eventsHemorrhagic strokeWide confidence intervalsAvailable followProtective reflexesCare centerClinical trials
2021
End-of-Life Care Decision-Making in Stroke
Gao L, Zhao C, Hwang D. End-of-Life Care Decision-Making in Stroke. Frontiers In Neurology 2021, 12: 702833. PMID: 34650502, PMCID: PMC8505717, DOI: 10.3389/fneur.2021.702833.Peer-Reviewed Original ResearchStroke patientsImmediate post-stroke periodIntensive care unit careLong-term functional outcomeCare decisionsCode status changePost-stroke periodIntensive care unitIntracerebral hemorrhage patientsLong-term disabilityLife care discussionsLife-sustaining therapyCause of deathLife care decisionsClinician's subjectivityIschemic strokeUnit careCare unitHemorrhage patientsPatient survivalFunctional outcomeProvider recommendationPatient preferencesCare discussionsTreatment goals
2017
Factors Considered by Clinicians when Prognosticating Intracerebral Hemorrhage Outcomes
Hwang DY, Chu SY, Dell CA, Sparks MJ, Watson TD, Langefeld CD, Comeau ME, Rosand J, Battey TWK, Koch S, Perez ML, James ML, McFarlin J, Osborne JL, Woo D, Kittner SJ, Sheth KN. Factors Considered by Clinicians when Prognosticating Intracerebral Hemorrhage Outcomes. Neurocritical Care 2017, 27: 316-325. PMID: 28744847, DOI: 10.1007/s12028-017-0430-7.Peer-Reviewed Original ResearchConceptsIntracerebral hemorrhageRadiographic factorsMethodsThis prospective observational studyClinical scalesPre-existing comorbiditiesProspective observational studyIntracerebral hemorrhage outcomesSubjective clinical judgmentJudgment of physiciansRankin ScaleICH patientsFunctional outcomeUS CentersObservational studyPrognostic scalesClinical teamClinical judgmentFUNC scoreNursesPhysiciansExamination componentsPatientsOutcomesPrognosticationClinicians
2015
Clinician judgment vs formal scales for predicting intracerebral hemorrhage outcomes
Hwang DY, Dell CA, Sparks MJ, Watson TD, Langefeld CD, Comeau ME, Rosand J, Battey TW, Koch S, Perez ML, James ML, McFarlin J, Osborne JL, Woo D, Kittner SJ, Sheth KN. Clinician judgment vs formal scales for predicting intracerebral hemorrhage outcomes. Neurology 2015, 86: 126-133. PMID: 26674335, PMCID: PMC4731687, DOI: 10.1212/wnl.0000000000002266.Peer-Reviewed Original ResearchConceptsModified Rankin ScaleICH scoreIntracerebral hemorrhageSubjective clinical judgmentFUNC scorePhysicians' predictionsPrognostic scalesClinical teamClinical judgmentUS tertiary care centerPatient's clinical teamTertiary care centerProspective observational studyIntracerebral hemorrhage outcomesSpontaneous intracerebral hemorrhageRankin ScaleComfort careICH patientsFunctional outcomeCare centerPatient admissionsObservational studyComfort measuresPrognostic instrumentNeurologic practice
2014
Subjective Judgments of Physicians and Nurses Are More Accurate Than Formal Clinical Scales in Predicting Functional Outcome After Intracerebral Hemorrhage (S45.006)
Hwang D, Dell C, Sparks M, Watson T, Langefeld C, Comeau M, Rosand J, Battey T, Koch S, Perez M, James M, McFarlin J, Osborne J, Woo D, Kittner S, Sheth K. Subjective Judgments of Physicians and Nurses Are More Accurate Than Formal Clinical Scales in Predicting Functional Outcome After Intracerebral Hemorrhage (S45.006). Neurology 2014, 82 DOI: 10.1212/wnl.82.10_supplement.s45.006.Peer-Reviewed Original Research