2022
Sex Differences in Endovascular Therapy for Ischemic Stroke: Results From the Get With The Guidelines–Stroke Registry
Demel S, Reeves M, Xu H, Xian Y, Mac Grory B, Fonarow G, Matsouaka R, Smith E, Saver J, Schwamm L. Sex Differences in Endovascular Therapy for Ischemic Stroke: Results From the Get With The Guidelines–Stroke Registry. Stroke 2022, 53: 3099-3106. PMID: 35880521, DOI: 10.1161/strokeaha.122.038491.Peer-Reviewed Original ResearchConceptsEndovascular therapyIschemic strokeHealth Stroke Scale scoreTreatment ratesGuidelines-Stroke hospitalsGuidelines-Stroke registryStroke Scale scoreAcute ischemic strokeSex differencesLarge vessel occlusionMultivariable regression analysisIschemic stroke dischargesEVT useHospital deathHospital mortalityASA guidelinesVessel occlusionOdds ratioScale scoreStroke dischargesSignificant sex differencesWomenNational InstituteMenStatistical adjustmentTemporal Trends in Racial and Ethnic Disparities in Endovascular Therapy in Acute Ischemic Stroke
Sheriff F, Xu H, Maud A, Gupta V, Vellipuram A, Fonarow G, Matsouaka R, Xian Y, Reeves M, Smith E, Saver J, Rodriguez G, Cruz‐Flores S, Schwamm L. Temporal Trends in Racial and Ethnic Disparities in Endovascular Therapy in Acute Ischemic Stroke. Journal Of The American Heart Association 2022, 11: e023212. PMID: 35229659, PMCID: PMC9075329, DOI: 10.1161/jaha.121.023212.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeEndovascular therapyEVT useIschemic strokeNon-Hispanic white patientsGuidelines-Stroke databaseHealth Stroke ScaleMortality/dischargeClinical trial publicationsPatient disparitiesDischarge homeEligible patientsNHW patientsStroke ScaleWhite patientsBlack patientsAsian patientsFunctional outcomeLarge cohortTrial publicationsPatientsFunctional independenceEthnic disparitiesRelated outcomesNational Institute
2021
Thrombolysis in Mild Stroke
Asdaghi N, Romano J, Gardener H, Campo-Bustillo I, Purdon B, Khan Y, Gulati D, Broderick J, Schwamm L, Smith E, Saver J, Sacco R, Khatri P. Thrombolysis in Mild Stroke. Stroke 2021, 52: e586-e589. PMID: 34496619, DOI: 10.1161/strokeaha.120.033466.Peer-Reviewed Original ResearchConceptsNIHSS scoreClinical practiceHealth Stroke Scale scoreMild ischemic stroke patientsMedian NIHSS scoreTrial of thrombolysisStroke Scale scoreIschemic stroke patientsProportion of patientsBroad clinical practiceRoutine clinical practiceSyndromic severityTrial cohortStroke patientsMild strokeMild patientsNeurological syndromeAlteplasePatientsScale scoreLess severityMaRISSComparable deficitsNational InstituteSeverityCTA Protocols in a Telestroke Network Improve Efficiency for Both Spoke and Hub Hospitals
Yu A, Regenhardt R, Whitney C, Schwamm L, Patel A, Stapleton C, Viswanathan A, Hirsch J, Lev M, Leslie-Mazwi T. CTA Protocols in a Telestroke Network Improve Efficiency for Both Spoke and Hub Hospitals. American Journal Of Neuroradiology 2021, 42: 435-440. PMID: 33541900, PMCID: PMC7959422, DOI: 10.3174/ajnr.a6950.Peer-Reviewed Original ResearchConceptsEndovascular thrombectomySpoke hospitalsTelestroke networkHub hospitalCTA protocolHealth Stroke Scale scoreEmergent large vessel occlusionStroke Scale scoreRate of patientsLarge vessel occlusionCTA utilizationThrombectomy ratesStroke triageThrombectomyNonsignificant increasePatientsScale scoreHospitalTriage processNational InstituteOverall rateCTAExtended windowHigher numberRetention rate
2020
Cryptogenic stroke: Contemporary trends, treatments, and outcomes in the United States.
Prabhakaran S, Messé S, Kleindorfer D, Smith E, Fonarow G, Xu H, Zhao X, Lytle B, Cigarroa J, Schwamm L. Cryptogenic stroke: Contemporary trends, treatments, and outcomes in the United States. Neurology Clinical Practice 2020, 10: 396-405. PMID: 33299667, PMCID: PMC7717635, DOI: 10.1212/cpj.0000000000000736.Peer-Reviewed Original ResearchCryptogenic strokeIschemic strokeStroke etiologyDischarge outcomesHospital treatmentHospital characteristicsMultivariable logistic regressionGWTG-StrokeStroke RegistryNationwide registryMultivariable analysisPatientsLower mortalityHigh mortalityNationwide dataLogistic regressionSubtypesStrokeNational InstituteScale scaleOutcomesTreatmentRegistryHospitalEtiology
2018
Factors associated with 1-year mortality after discharge for acute stroke: what matters?
Magdon-Ismail Z, Ledneva T, Sun M, Schwamm L, Sherman B, Qian F, Bettger J, Xian Y, Stein J. Factors associated with 1-year mortality after discharge for acute stroke: what matters? Topics In Stroke Rehabilitation 2018, 25: 576-583. PMID: 30281414, DOI: 10.1080/10749357.2018.1499303.Peer-Reviewed Original ResearchConceptsInpatient rehabilitation facilitySkilled nursing facilitiesAcute strokeDischarge destinationHealth Stroke ScaleHigher National InstitutesRetrospective cohort studyLong-term outcomesLong-term survivalCause mortalityStroke ScaleCohort studyIschemic strokeAmbulation statusIntracerebral hemorrhageMean ageMultivariate regression modelClinical dataNursing facilitiesRehabilitation facilityTherapeutic targetOlder ageMortalityStrokeNational InstituteDelays in the Air or Ground Transfer of Patients for Endovascular Thrombectomy
Regenhardt RW, Mecca AP, Flavin SA, Boulouis G, Lauer A, Zachrison KS, Boomhower J, Patel AB, Hirsch JA, Schwamm LH, Leslie-Mazwi TM. Delays in the Air or Ground Transfer of Patients for Endovascular Thrombectomy. Stroke 2018, 49: 1419-1425. PMID: 29712881, PMCID: PMC5970980, DOI: 10.1161/strokeaha.118.020618.Peer-Reviewed Original ResearchConceptsEndovascular therapySpoke hospitalsTelestroke networkUnderwent endovascular therapyEndovascular thrombectomyHealth StrokeIschemic strokeClinical outcomesMedian delayHub hospitalInclusion criteriaTelestroke consultsMultivariable regressionTreatment opportunitiesPossible predictorsTreatment ratesPatientsHospitalDaytime transfersLong transfer timesNational Institute
2017
Ischemic Stroke Profile, Risk Factors, and Outcomes in India
Sylaja P, Pandian J, Kaul S, Srivastava M, Khurana D, Schwamm L, Kesav P, Arora D, Pannu A, Thankachan T, Singhal A. Ischemic Stroke Profile, Risk Factors, and Outcomes in India. Stroke 2017, 49: 219-222. PMID: 29167386, PMCID: PMC5742046, DOI: 10.1161/strokeaha.117.018700.Peer-Reviewed Original ResearchConceptsAdmission National InstitutesHealth Stroke ScaleStroke ScaleIschemic strokeDiabetes mellitusRisk factorsHealth Stroke Scale scoreLower admission National InstitutesMedian admission National InstitutesNational InstituteRankin Scale score 0Stroke etiologic subtypesIntra-arterial thrombolysisStroke Scale scoreAcademic tertiary hospitalCommon risk factorsMagnetic resonance imagingHospital mortalityEtiologic subtypesStroke careStroke ProjectTertiary hospitalAtrial fibrillationStroke guidelinesMean ageIncrease in Endovascular Therapy in Get With The Guidelines-Stroke After the Publication of Pivotal Trials
Smith E, Saver J, Cox M, Liang L, Matsouaka R, Xian Y, Bhatt D, Fonarow G, Schwamm L. Increase in Endovascular Therapy in Get With The Guidelines-Stroke After the Publication of Pivotal Trials. Circulation 2017, 136: 2303-2310. PMID: 28982689, DOI: 10.1161/circulationaha.117.031097.Peer-Reviewed Original ResearchConceptsEndovascular thrombectomyEVT useEligible patientsIschemic strokePivotal trialsCase volumeStroke systemsHealth Stroke Scale scoreGuidelines-Stroke programStroke Scale scoreMean case volumeGuidelines-StrokeEndovascular therapyMore patientsPatient eligibilityPatientsClinical practiceScale scoreHospitalStrokeTrialsNational InstituteStroke durationLinear regressionThrombectomyImmediate Vascular Imaging Needed for Efficient Triage of Patients With Acute Ischemic Stroke Initially Admitted to Nonthrombectomy Centers
Boulouis G, Siddiqui K, Lauer A, Charidimou A, Regenhardt R, Viswanathan A, Leslie-Mazwi T, Rost N, Schwamm L. Immediate Vascular Imaging Needed for Efficient Triage of Patients With Acute Ischemic Stroke Initially Admitted to Nonthrombectomy Centers. Stroke 2017, 48: 2297-2300. PMID: 28687641, DOI: 10.1161/strokeaha.117.017607.Peer-Reviewed Original ResearchConceptsThrombectomy-capable stroke centersEndovascular thrombectomyVascular imagingCurrent guidelinesAlberta Stroke Program Early CT ScoreUnnecessary transfersHealth Stroke ScaleAcute ischemic strokeMain outcome variablesBaseline vascularStroke ScaleIschemic strokeStroke centersCT scoreFutile transfersPatientsEfficient triageHospitalYielded sensitivityOutcome variablesOptimal selection criteriaNational InstituteStrokeImagingOcclusion levelCoexistent Sickle Cell Disease Has No Impact on the Safety or Outcome of Lytic Therapy in Acute Ischemic Stroke
Adams R, Cox M, Ozark S, Kanter J, Schulte P, Xian Y, Fonarow G, Smith E, Schwamm L. Coexistent Sickle Cell Disease Has No Impact on the Safety or Outcome of Lytic Therapy in Acute Ischemic Stroke. Stroke 2017, 48: 686-691. PMID: 28183857, DOI: 10.1161/strokeaha.116.015412.Peer-Reviewed Original ResearchConceptsSickle cell diseaseAcute ischemic strokeIschemic strokeThrombolytic therapyCell diseaseMultivariable logistic regression modelAdmission National InstitutesGuidelines-Stroke registrySymptomatic intracranial hemorrhageHealth Stroke ScaleIntracranial hemorrhage rateAmerican Stroke AssociationAmerican Heart AssociationNational Heart LungNational InstituteLogistic regression modelsLytic therapyStroke ScaleTPA useBlood pressureDischarge outcomesHemorrhage rateStroke patientsBlood InstituteExchange transfusion
2016
Baseline Predictors of Poor Outcome in Patients Too Good to Treat With Intravenous Thrombolysis
Ali S, Siddiqui K, Ay H, Silverman S, Singhal A, Viswanathan A, Rost N, Lev M, Schwamm L. Baseline Predictors of Poor Outcome in Patients Too Good to Treat With Intravenous Thrombolysis. Stroke 2016, 47: 2986-2992. PMID: 27834750, DOI: 10.1161/strokeaha.116.014871.Peer-Reviewed Original ResearchConceptsIntravenous tissue-type plasminogen activatorHealth Stroke ScaleTissue-type plasminogen activatorPoor outcomeIntravenous thrombolysisStroke ScaleMultivariable analysisPlasminogen activatorHigher median National InstitutesConsecutive stroke admissionsCurrent safety profileGuidelines-Stroke databaseInitial National InstitutesMedian National InstitutesThird of patientsVascular risk factorsNational InstituteSkilled nursing facilitiesMultifocal infarctionPoor collateralsStroke admissionsImaging predictorsInpatient rehabilitationSafety profileImaging featuresAcute Stroke Imaging Research Roadmap III Imaging Selection and Outcomes in Acute Stroke Reperfusion Clinical Trials
Warach S, Luby M, Albers G, Bammer R, Bivard A, Campbell B, Derdeyn C, Heit J, Khatri P, Lansberg M, Liebeskind D, Majoie C, Marks M, Menon B, Muir K, Parsons M, Vagal A, Yoo A, Alexandrov A, Baron J, Fiorella D, Furlan A, Puig J, Schellinger P, Wintermark M, Ansari S, Aviv R, Barreto A, Broderick J, Christensen S, Davis S, Demchuk A, Dippel D, Donnan G, Fiebach J, Fiehler J, Houser G, Grotta J, Hacke W, Hill M, Hsia A, Jovin T, Köhrmann M, Latour L, Leigh R, Lees K, Lev M, Marshall R, Mocco J, Nadareishvili Z, Nogueira R, Olivot J, Palesch Y, Pedraza S, Sasaki M, Saver J, Savitz S, Schwamm L, Simpkins A, Smith W, Thijs V, Thomalla G, Wechsler L, Wu O, Zaharchuk G, Zaidat O. Acute Stroke Imaging Research Roadmap III Imaging Selection and Outcomes in Acute Stroke Reperfusion Clinical Trials. Stroke 2016, 47: 1389-1398. PMID: 27073243, PMCID: PMC6058693, DOI: 10.1161/strokeaha.115.012364.Peer-Reviewed Original ResearchConceptsClinical trialsEndovascular trialsImaging Working GroupFinal infarct volumeLarge vessel occlusionProspective clinical trialsImaging sessionAmerican SocietyOptimal imaging methodInfarct volumeStroke neurologistsEndovascular treatmentPooled analysisTherapy clinical trialsVessel occlusionImaging selectionGood collateralsNeurovascular imagingConsensus recommendationsUS FoodDrug AdministrationNeurological disordersPooled dataTrialsNational InstituteDistinct Short-Term Outcomes in Patients With Mild Versus Rapidly Improving Stroke Not Treated With Thrombolytics
Romano J, Smith E, Liang L, Gardener H, Campo-Bustillo I, Khatri P, Bhatt D, Fonarow G, Sacco R, Schwamm L. Distinct Short-Term Outcomes in Patients With Mild Versus Rapidly Improving Stroke Not Treated With Thrombolytics. Stroke 2016, 47: 1278-1285. PMID: 26987870, DOI: 10.1161/strokeaha.115.011528.Peer-Reviewed Original ResearchConceptsHealth Stroke ScaleShort-term outcomesMild strokeHome dischargeIndependent ambulationStroke ScaleHealth Stroke Scale 0National InstituteGuidelines-Stroke registryVascular risk factorsLength of stayHospital mortalityHospital deathIschemic strokeSymptom onsetDischarge outcomesStroke presentationStroke symptomsHospital covariatesAdjusted outcomesRisk factorsWorse outcomesMultivariable modelRetrospective analysisGreater severity
2015
Variation and Trends in the Documentation of National Institutes of Health Stroke Scale in GWTG-Stroke Hospitals
Reeves M, Smith E, Fonarow G, Zhao X, Thompson M, Peterson E, Schwamm L, Olson D. Variation and Trends in the Documentation of National Institutes of Health Stroke Scale in GWTG-Stroke Hospitals. Circulation Cardiovascular Quality And Outcomes 2015, 8: s90-s98. PMID: 26515215, DOI: 10.1161/circoutcomes.115.001775.Peer-Reviewed Original ResearchConceptsGWTG-Stroke hospitalsHealth Stroke ScaleNIHSS scoreDocumentation ratesNIHSS dataStroke ScaleMultivariable logistic regression modelAcute ischemic strokeHospital-level factorsPrimary stroke centerImportant prognostic variablesPatient-level predictorsNational InstituteLogistic regression modelsMedian NIHSSIschemic strokeStroke centersThrombolysis candidatesClinical registryPrognostic variablesNIHSSHospitalPatientsStrokeLow documentationOutcomes in Mild Acute Ischemic Stroke Treated With Intravenous Thrombolysis: A Retrospective Analysis of the Get With the Guidelines–Stroke Registry
Romano J, Smith E, Liang L, Gardener H, Camp S, Shuey L, Cook A, Campo-Bustillo I, Khatri P, Bhatt D, Fonarow G, Sacco R, Schwamm L. Outcomes in Mild Acute Ischemic Stroke Treated With Intravenous Thrombolysis: A Retrospective Analysis of the Get With the Guidelines–Stroke Registry. JAMA Neurology 2015, 72: 423-431. PMID: 25642650, DOI: 10.1001/jamaneurol.2014.4354.Peer-Reviewed Original ResearchConceptsRecombinant tissue plasminogen activatorHealth Stroke Scale scoreStroke Scale scoreSymptomatic intracranial hemorrhageShort-term outcomesIntravenous recombinant tissue plasminogen activatorGuidelines-Stroke registrySerious systemic hemorrhageAcute ischemic strokeLength of stayMild strokeTreatment complicationsIschemic strokeIntracranial hemorrhageScale scoreSymptom onsetSerious complicationsRetrospective analysisSystemic hemorrhageMild acute ischemic strokeNational InstituteWorse short-term outcomesBaseline National InstitutesHigher National InstitutesQuality improvement registry
2014
Intravenous Fibrinolysis Eligibility: A Survey of Stroke Clinicians' Practice Patterns and Review of the Literature
De Los Rios F, Kleindorfer D, Guzik A, Ortega-Gutierrez S, Sangha N, Kumar G, Grotta J, Lee J, Meyer B, Schwamm L, Khatri P, Investigators S. Intravenous Fibrinolysis Eligibility: A Survey of Stroke Clinicians' Practice Patterns and Review of the Literature. Journal Of Stroke And Cerebrovascular Diseases 2014, 23: 2130-2138. PMID: 25113084, PMCID: PMC4157964, DOI: 10.1016/j.jstrokecerebrovasdis.2014.03.024.Peer-Reviewed Original ResearchConceptsStroke cliniciansPractice patternsEligible patientsSymptom onsetEuropean Cooperative Acute Stroke Study-III criteriaIntravenous recombinant tissue plasminogen activator useCurrent American Heart Association guidelinesRecombinant tissue plasminogen activator useTissue plasminogen activator useAmerican Heart Association guidelinesHealth Stroke ScaleHeart Association guidelinesHour time frameClinician practice patternsNational InstituteSevere strokeStroke ScaleIschemic strokeMild strokeAssociation guidelinesMost cliniciansElderly individualsEligibility criteriaDrug AdministrationInvestigator meeting
2013
Characteristics and Outcomes Among Patients Transferred to a Regional Comprehensive Stroke Center for Tertiary Care
Ali S, Singhal A, Viswanathan A, Rost N, Schwamm L. Characteristics and Outcomes Among Patients Transferred to a Regional Comprehensive Stroke Center for Tertiary Care. Stroke 2013, 44: 3148-3153. PMID: 24021682, DOI: 10.1161/strokeaha.113.002493.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeIntravenous tissue plasminogen activatorInitial National InstitutesComprehensive stroke centerHospital mortalityIschemic strokeTissue plasminogen activatorStroke centersStroke careDoor patientsHealth Stroke Scale scoreMedian initial National InstitutesAcute ischemic stroke carePlasminogen activatorLonger hospital lengthStroke care centerHealth Stroke ScaleStroke Scale scoreCoronary artery diseaseIschemic stroke careAcute care hospitalsNational InstituteHospital lengthSevere strokeStroke Registry
2012
Risk Score for Intracranial Hemorrhage in Patients With Acute Ischemic Stroke Treated With Intravenous Tissue-Type Plasminogen Activator
Menon B, Saver J, Prabhakaran S, Reeves M, Liang L, Olson D, Peterson E, Hernandez A, Fonarow G, Schwamm L, Smith E. Risk Score for Intracranial Hemorrhage in Patients With Acute Ischemic Stroke Treated With Intravenous Tissue-Type Plasminogen Activator. Stroke 2012, 43: 2293-2299. PMID: 22811458, DOI: 10.1161/strokeaha.112.660415.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBlood PressureCerebral HemorrhageCohort StudiesData Interpretation, StatisticalEthnicityFemaleFibrinolytic AgentsHospitalsHumansLogistic ModelsMaleMiddle AgedMultivariate AnalysisPredictive Value of TestsRisk AssessmentRisk FactorsStrokeTissue Plasminogen ActivatorTreatment OutcomeConceptsIntravenous tissue-type plasminogen activatorSymptomatic intracranial hemorrhageTissue-type plasminogen activatorSICH riskIschemic strokeSymptom onsetIntracranial hemorrhageValidation cohortC-statisticPlasminogen activatorIntravenous tissue-type plasminogen activator treatmentRisk of sICHTissue-type plasminogen activator treatmentHigher baseline National InstitutesHigher systolic blood pressureDerivation sampleBaseline National InstitutesHealth Stroke ScaleStroke symptom onsetAcute ischemic strokeSystolic blood pressurePlasminogen activator treatmentMultivariable logistic regressionHigh blood glucoseNational InstituteRelationship of National Institutes of Health Stroke Scale to 30-Day Mortality in Medicare Beneficiaries With Acute Ischemic Stroke
Fonarow G, Saver J, Smith E, Broderick J, Kleindorfer D, Sacco R, Pan W, Olson D, Hernandez A, Peterson E, Schwamm L. Relationship of National Institutes of Health Stroke Scale to 30-Day Mortality in Medicare Beneficiaries With Acute Ischemic Stroke. Journal Of The American Heart Association 2012, 1: 42-50. DOI: 10.1161/xjaha.111.000034.Peer-Reviewed Original Research