2023
Outcomes after ischemic stroke for dual-eligible Medicare-Medicaid beneficiaries in the United States
Leifheit E, Wang Y, Goldstein L, Lichtman J. Outcomes after ischemic stroke for dual-eligible Medicare-Medicaid beneficiaries in the United States. PLOS ONE 2023, 18: e0292546. PMID: 37797070, PMCID: PMC10553827, DOI: 10.1371/journal.pone.0292546.Peer-Reviewed Original ResearchConceptsStroke hospitalization ratesMedicare beneficiariesIschemic strokeHospitalization ratesUS acute care hospitalsDual-eligible patientsLong-term mortalityUS Medicare beneficiariesIschemic stroke hospitalizationsPost-stroke outcomesAcute care hospitalsService Medicare beneficiariesDual-eligible statusDual-eligible beneficiariesPercentage of beneficiariesCause readmissionHigher readmissionClinical factorsDual eligibilityAdjusted analysisPoor outcomeStroke patientsCox regressionStroke hospitalizationsPrincipal diagnosisAssociation of short-term hospital-level outcome metrics with 1-year mortality and recurrence for US Medicare beneficiaries with ischemic stroke
Wang Y, Leifheit E, Goldstein L, Lichtman J. Association of short-term hospital-level outcome metrics with 1-year mortality and recurrence for US Medicare beneficiaries with ischemic stroke. PLOS ONE 2023, 18: e0289790. PMID: 37561680, PMCID: PMC10414659, DOI: 10.1371/journal.pone.0289790.Peer-Reviewed Original ResearchConceptsIschemic strokeInverse probability weightsStroke patientsCause mortalityOutcome metricsLower riskUS hospitalsBetter long-term outcomesRecurrent stroke rateIschemic stroke recurrenceIschemic stroke patientsLong-term outcomesUS Medicare beneficiariesPerformance categoriesIntermediate hospitalsRecurrent strokeStroke recurrenceCohort studyClinical factorsRecurrence ratePrincipal diagnosisPatient riskStroke rateReadmission measuresCox model
2011
30-Day Mortality and Readmission After Hemorrhagic Stroke Among Medicare Beneficiaries in Joint Commission Primary Stroke Center-Certified and Noncertified Hospitals
Lichtman JH, Jones SB, Leifheit-Limson EC, Wang Y, Goldstein LB. 30-Day Mortality and Readmission After Hemorrhagic Stroke Among Medicare Beneficiaries in Joint Commission Primary Stroke Center-Certified and Noncertified Hospitals. Stroke 2011, 42: 3387-3391. PMID: 22033986, PMCID: PMC3292255, DOI: 10.1161/strokeaha.111.622613.Peer-Reviewed Original ResearchConceptsSubarachnoid hemorrhageIntracerebral hemorrhageReadmission ratesHemorrhagic strokeMedicare beneficiariesJoint Commission Primary Stroke CentersLower risk-adjusted mortality ratesCox proportional hazards regressionRisk-adjusted readmission ratesRisk-adjusted mortality ratesIschemic stroke patientsPrimary discharge diagnosisPrimary stroke centerProportional hazards regressionService Medicare beneficiariesEffects of careHospital mortalityStroke centersStroke patientsDischarge diagnosisHazards regressionMortality rateBetter outcomesHospitalPatients
2010
Use of Antithrombotic Medications Among Elderly Ischemic Stroke Patients
Lichtman JH, Naert L, Allen NB, Watanabe E, Jones SB, Barry LC, Bravata DM, Goldstein LB. Use of Antithrombotic Medications Among Elderly Ischemic Stroke Patients. Circulation Cardiovascular Quality And Outcomes 2010, 4: 30-38. PMID: 21098780, PMCID: PMC3073519, DOI: 10.1161/circoutcomes.109.850883.Peer-Reviewed Original ResearchConceptsDeep vein thrombosis prophylaxisElderly ischemic stroke patientsIschemic stroke patientsThrombosis prophylaxisAntithrombotic medicationSkilled nursing facilitiesEligible patientsAntithrombotic therapyIschemic strokeAtrial fibrillationStroke patientsNursing facilitiesPatients ages 85 yearsSecondary stroke preventionAge 85 yearsRates of receiptLow treatment ratesRate of treatmentAntiplatelet medicationsStroke preventionEffect of agePatient agePatient characteristicsAntiplatelet drugsMedicare fee
2009
Hospital Arrival Time and Intravenous t-PA Use in US Academic Medical Centers, 2001–2004
Lichtman JH, Watanabe E, Allen NB, Jones SB, Dostal J, Goldstein LB. Hospital Arrival Time and Intravenous t-PA Use in US Academic Medical Centers, 2001–2004. Stroke 2009, 40: 3845-3850. PMID: 19797697, DOI: 10.1161/strokeaha.109.562660.Peer-Reviewed Original ResearchMeSH KeywordsAcademic Medical CentersAgedAged, 80 and overBlack or African AmericanBrain IschemiaEmergency Medical ServicesEmergency Service, HospitalFemaleHealth Services AccessibilityHumansInjections, IntravenousIntracranial ThrombosisMaleMiddle AgedQuality of Health CareSeverity of Illness IndexStrokeThrombolytic TherapyTime FactorsTissue Plasminogen ActivatorTransportation of PatientsUnited StatesWhite PeopleConceptsIschemic stroke patientsSymptom onsetT-PA useStroke patientsHospital arrivalIntravenous tissue-type plasminogen activatorConsecutive ischemic stroke patientsEarly hospital arrivalPercentage of patientsUS academic centersHospital arrival timeRisk-adjusted analysisMultivariate logistic regressionCare-seeking behaviorAcademic medical centerTissue-type plasminogen activatorClinical characteristicsSevere strokePatient characteristicsBlack patientsEmergency departmentMedical recordsHospital careMedical CenterLower oddsDiagnostic Evaluation for Patients with Ischemic Stroke: Are There Sex Differences?
Watanabe E, Allen NB, Dostal J, Sama D, Claus EB, Goldstein LB, Lichtman JH. Diagnostic Evaluation for Patients with Ischemic Stroke: Are There Sex Differences? Cerebrovascular Diseases 2009, 27: 450-455. PMID: 19295208, DOI: 10.1159/000209240.Peer-Reviewed Original ResearchConceptsIschemic stroke patientsStroke patientsIschemic strokeAcademic hospitalDiagnostic evaluationConsecutive ischemic stroke patientsDiagnostic testsAcute coronary symptomsCarotid artery ultrasoundManagement of womenUS academic medical centersMultivariate logistic regressionUse of neuroimagingAcademic medical centerUS academic hospitalsSex-associated differencesSex differencesClinical factorsCoronary symptomsPotential confoundersMedical recordsCarotid arteryMedical CenterPatientsLogistic regression
2001
Utilization of Intravenous Tissue-Type Plasminogen Activator for Ischemic Stroke at Academic Medical Centers
Johnston S, Fung L, Gillum L, Smith W, Brass L, Lichtman J, Brown A. Utilization of Intravenous Tissue-Type Plasminogen Activator for Ischemic Stroke at Academic Medical Centers. Stroke 2001, 32: 1061-1068. PMID: 11340210, DOI: 10.1161/01.str.32.5.1061.Peer-Reviewed Original ResearchMeSH KeywordsAcademic Medical CentersAgedBlack or African AmericanBrain IschemiaCohort StudiesContraindicationsDatabases, FactualDrug Utilization ReviewFemaleFibrinolytic AgentsHumansLogistic ModelsMaleMiddle AgedPatient DischargeStrokeThrombolytic TherapyTissue Plasminogen ActivatorUnited StatesWhite PeopleConceptsAcademic medical centerTissue-type plasminogen activatorIschemic strokeMedical CenterIntravenous tissue-type plasminogen activatorConsecutive ischemic stroke casesAfrican AmericansPlasminogen activatorIschemic stroke patientsUS academic medical centersMultivariable logistic regressionMedical insuranceIschemic stroke casesMedical insurance typePrivate medical insuranceTPA useStroke severityStroke patientsStroke casesMedical historyInsurance typeMedical recordsUnivariate analysisContraindicationsLogistic regression