2023
Association 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 modelAssociations Between Long-Term Air Pollutant Exposure and 30-Day All-Cause Hospital Readmissions in US Patients With Stroke
Tran P, Warren J, Leifheit E, Goldstein L, Lichtman J. Associations Between Long-Term Air Pollutant Exposure and 30-Day All-Cause Hospital Readmissions in US Patients With Stroke. Stroke 2023, 54: e126-e129. PMID: 36729388, PMCID: PMC11059199, DOI: 10.1161/strokeaha.122.042265.Peer-Reviewed Original ResearchConceptsLong-term air pollutant exposureAir pollutant exposureCause hospital readmissionHospital readmissionPollutant exposureMedicare beneficiaries agePerformance categoriesMatter 2.5Sulfur dioxide exposureCause readmission measureIschemic strokeStroke incidenceUS patientsHospital characteristicsSD increaseReadmissionCox modelReadmission measuresBeneficiaries ageLong-term exposureStrokePatientsMedicaid ServicesParticulate matter 2.5US fee
2022
The association of marital/partner status with patient-reported health outcomes following acute myocardial infarction or stroke: Protocol for a systematic review and meta-analysis
Zhu C, Tran P, Leifheit E, Spatz E, Dreyer R, Nyhan K, Wang S, Goldstein L, Lichtman J. The association of marital/partner status with patient-reported health outcomes following acute myocardial infarction or stroke: Protocol for a systematic review and meta-analysis. PLOS ONE 2022, 17: e0267771. PMID: 36378664, PMCID: PMC9665376, DOI: 10.1371/journal.pone.0267771.Peer-Reviewed Original ResearchConceptsPatient-reported outcome measuresAcute myocardial infarctionMarital/partner statusPartner statusMyocardial infarctionHealth outcomesPatient-reported health outcomesPROSPERO registration numberRisk of biasPatient-centered factorsPeer-reviewed journalsPrimary outcomeSubgroup analysisThird reviewerOutcome measuresRegistration numberLower mortalitySystematic reviewEthics approvalStrokePartner supportMale participantsInfarctionFull textOutcomes
2013
Seasonal Variation in 30-Day Mortality After Stroke
Lichtman JH, Jones SB, Wang Y, Leifheit-Limson EC, Goldstein LB. Seasonal Variation in 30-Day Mortality After Stroke. Stroke 2013, 44: 531-533. PMID: 23299494, PMCID: PMC3555561, DOI: 10.1161/strokeaha.112.670547.Peer-Reviewed Original Research
2012
30-Day Risk-Standardized Mortality and Readmission Rates After Ischemic Stroke in Critical Access Hospitals
Lichtman JH, Leifheit-Limson EC, Jones SB, Wang Y, Goldstein LB. 30-Day Risk-Standardized Mortality and Readmission Rates After Ischemic Stroke in Critical Access Hospitals. Stroke 2012, 43: 2741-2747. PMID: 22935397, PMCID: PMC3547601, DOI: 10.1161/strokeaha.112.665646.Peer-Reviewed Original ResearchConceptsRisk-standardized mortality ratesRisk-standardized readmission ratesAnnual hospital volumeIschemic strokeReadmission ratesHospital volumeVolume quartileHighest risk-standardized mortality ratesPoor short-term outcomeMedicare beneficiaries 65 yearsService Medicare beneficiaries 65 yearsHighest volume quartileHospital volume quartilesPrimary discharge diagnosisLow-volume hospitalsShort-term outcomesBeneficiaries 65 years
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 outcomesHospitalPatientsOutcomes after ischemic stroke for hospitals with and without Joint Commission–certified primary stroke centers
Lichtman JH, Jones SB, Wang Y, Watanabe E, Leifheit-Limson E, Goldstein LB. Outcomes after ischemic stroke for hospitals with and without Joint Commission–certified primary stroke centers. Neurology 2011, 76: 1976-1982. PMID: 21543736, PMCID: PMC3109877, DOI: 10.1212/wnl.0b013e31821e54f3.Peer-Reviewed Original ResearchConceptsPrimary stroke centerRisk-standardized mortalityJoint CommissionPSC hospitalsIschemic strokeReadmission ratesStroke centersService Medicare beneficiariesHospital referral regionsIschemic stroke dischargesPSC certificationPatient demographicsComorbid conditionsStudy cohortMortality outcomesNational averagePrimary diagnosisReferral regionsMedicare beneficiariesHierarchical linear regression modelsHospitalStroke dischargesLinear regression modelsLower ratesStroke
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 feePredictors of Hospital Readmission After Stroke
Lichtman JH, Leifheit-Limson EC, Jones SB, Watanabe E, Bernheim SM, Phipps MS, Bhat KR, Savage SV, Goldstein LB. Predictors of Hospital Readmission After Stroke. Stroke 2010, 41: 2525-2533. PMID: 20930150, PMCID: PMC3021413, DOI: 10.1161/strokeaha.110.599159.Peer-Reviewed Original ResearchConceptsReadmission ratesOvid Evidence-Based Medicine ReviewsReadmission performanceEvidence-Based Medicine ReviewsRisk-adjusted readmission ratesHospital readmission performancePredictors of readmissionPatient-level factorsHospital readmission ratesQuality of careSystem-level factorsComposite outcomeHospital readmissionMedicine ReviewsReadmission riskStroke hospitalizationsCare factorsPatient riskMultivariable modelInclusion criteriaReadmissionStroke definitionsEligible publicationsRisk scoreHospital levelTrends in One-Year Recurrent Ischemic Stroke among the Elderly in the USA: 1994–2002
Allen NB, Holford TR, Bracken MB, Goldstein LB, Howard G, Wang Y, Lichtman JH. Trends in One-Year Recurrent Ischemic Stroke among the Elderly in the USA: 1994–2002. Cerebrovascular Diseases 2010, 30: 525-532. PMID: 20881382, PMCID: PMC2978738, DOI: 10.1159/000319028.Peer-Reviewed Original Research
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 oddsStroke Patient Outcomes in US Hospitals Before the Start of the Joint Commission Primary Stroke Center Certification Program
Lichtman JH, Allen NB, Wang Y, Watanabe E, Jones SB, Goldstein LB. Stroke Patient Outcomes in US Hospitals Before the Start of the Joint Commission Primary Stroke Center Certification Program. Stroke 2009, 40: 3574-3579. PMID: 19797179, PMCID: PMC2782858, DOI: 10.1161/strokeaha.109.561472.Peer-Reviewed Original ResearchConceptsPrimary stroke centerCross-sectional studyBetter outcomesJoint CommissionHospital mortalityStroke centersCox proportional hazards modelStroke center certificationStroke patient outcomesProportional hazards modelYears of ageHierarchical logistic regressionIschemic strokeCenter certificationPatient outcomesMedicare feeHazards modelUS hospitalsService beneficiariesHospitalLogistic regressionPatientsMortalityRisk adjustmentStudy sampleDiagnostic 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 regressionElderly Women Have Lower Rates of Stroke, Cardiovascular Events, and Mortality After Hospitalization for Transient Ischemic Attack
Lichtman JH, Jones SB, Watanabe E, Allen NB, Wang Y, Howard VJ, Goldstein LB. Elderly Women Have Lower Rates of Stroke, Cardiovascular Events, and Mortality After Hospitalization for Transient Ischemic Attack. Stroke 2009, 40: 2116-2122. PMID: 19228857, PMCID: PMC2757938, DOI: 10.1161/strokeaha.108.543009.Peer-Reviewed Original ResearchConceptsTransient ischemic attackCoronary artery diseaseArtery diseaseIschemic attackCardiovascular eventsOutcomes 30 daysService Medicare patientsRisk-adjusted analysisProportional hazards modelYears of ageRandom effects logistic modelSex-related differencesSex-based differencesCardiac comorbiditiesTIA admissionsCause readmissionElderly patientsHospital dischargePrior hospitalizationBetter prognosisUnadjusted ratesMedical historyElderly womenMedicare patientsHazards model
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