2024
Temperature Control Parameters Are Important: Earlier Preinduction Is Associated With Improved Outcomes Following Out-of-Hospital Cardiac Arrest
Beekman R, Kim N, Nguyen C, McGinniss G, Deng Y, Kitlen E, Garcia G, Wira C, Khosla A, Johnson J, Miller P, Perman S, Sheth K, Greer D, Gilmore E. Temperature Control Parameters Are Important: Earlier Preinduction Is Associated With Improved Outcomes Following Out-of-Hospital Cardiac Arrest. Annals Of Emergency Medicine 2024, 84: 549-559. PMID: 39033449, DOI: 10.1016/j.annemergmed.2024.06.007.Peer-Reviewed Original ResearchOut-of-hospital cardiac arrestNeurological outcomeDevice cohortCardiac arrestOut-of-hospital cardiac arrest patientsConsecutive out-of-hospital cardiac arrestPreinduction timeInterquartile rangeAssociated with improved outcomesCardiac arrest patientsProportion of patientsMultivariate logistic regression modelInverse probability of treatmentDevice timeInverse probability treatment weightsProbability of treatmentProspective trialsOHCA patientsArrest patientsClinical outcomesLogistic regression modelsCenter studyEarly initiationSecondary outcomesTreatment weightingConsidering Adverse Effects of Common Antihypertensive Medications in the ED
Wira C, Kearns T, Fleming-Nouri A, Tyrrell J, Wira C, Aydin A. Considering Adverse Effects of Common Antihypertensive Medications in the ED. Current Hypertension Reports 2024, 26: 355-368. PMID: 38687403, DOI: 10.1007/s11906-024-01304-5.Peer-Reviewed Original ResearchCan Clinical Scores Predict the Presence of Hypoxic Ischemic Brain Injury on Early Head Computed Tomography After Cardiac Arrest? (P6-2.001)
Nguyen C, Molligoda B, Kim N, Kitlen E, Wira C, Perman S, Khosla A, Miller P, Greer D, Gilmore E, Beekman R. Can Clinical Scores Predict the Presence of Hypoxic Ischemic Brain Injury on Early Head Computed Tomography After Cardiac Arrest? (P6-2.001). Neurology 2024, 102 DOI: 10.1212/wnl.0000000000206255.Peer-Reviewed Original ResearchThe Impact of Socioeconomic Status on Risk for Brain Death Following Out-of-Hospital Cardiac Arrest (P1-4.014)
Fung C, Kitlen E, Nguyen C, Kim N, Wira C, Perman S, Khosla A, Miller P, Greer D, Gilmore E, Beekman R. The Impact of Socioeconomic Status on Risk for Brain Death Following Out-of-Hospital Cardiac Arrest (P1-4.014). Neurology 2024, 102 DOI: 10.1212/wnl.0000000000206574.Peer-Reviewed Original Research
2023
Association of Neighborhood-Level Socioeconomic Factors With Delay to Hospital Arrival in Patients With Acute Stroke
Forman R, Okumu R, Mageid R, Baker A, Neu D, Parker R, Peyravi R, Schindler J, Sansing L, Sheth K, de Havenon A, Jasne A, Narula R, Wira C, Warren J, Sharma R. Association of Neighborhood-Level Socioeconomic Factors With Delay to Hospital Arrival in Patients With Acute Stroke. Neurology 2023, 102: e207764. PMID: 38165368, PMCID: PMC10834135, DOI: 10.1212/wnl.0000000000207764.Peer-Reviewed Original ResearchConceptsEmergency department arrival timesEmergency medical servicesLate presentationAcute ischemic stroke therapyYale-New Haven HospitalGuidelines-Stroke registryNeighborhood-level socioeconomic factorsPatient-level factorsRetrospective observational studyIschemic stroke therapyMixed-effects logistic regression modelNon-white patientsNon-white raceUnivariate logistic regressionNew Haven HospitalLogistic regression modelsHospital presentationTreatment ineligibilityStroke RegistryAcute strokeHospital arrivalStroke therapyUnivariate analysisObservational studyPatientsDevelopment and validation of a novel score to predict brain death after out-of-hospital cardiac arrest
Kitlen E, Kim N, Rubenstein A, Keenan C, Garcia G, Khosla A, Johnson J, Miller P, Wira C, Greer D, Gilmore E, Beekman R. Development and validation of a novel score to predict brain death after out-of-hospital cardiac arrest. Resuscitation 2023, 192: 109955. PMID: 37661012, DOI: 10.1016/j.resuscitation.2023.109955.Peer-Reviewed Original ResearchConceptsHospital cardiac arrestBrain deathCardiac arrestOptimal cutEtiology of arrestDeath risk scoreNon-shockable rhythmOperator characteristic curveHours of arrestCenter cohortIndependent predictorsSulcal effacementUnResponsiveness (FOUR) scoreValidation cohortDevelopment cohortMAIN OUTCOMEHigh riskRisk scoreAcademic centersNovel scoreOHCACohortInternal validationRadiology reportsCharacteristic curveIdentification of White Matter Hyperintensities in Routine Emergency Department Visits Using Portable Bedside Magnetic Resonance Imaging
de Havenon A, Parasuram N, Crawford A, Mazurek M, Chavva I, Yadlapalli V, Iglesias J, Rosen M, Falcone G, Payabvash S, Sze G, Sharma R, Schiff S, Safdar B, Wira C, Kimberly W, Sheth K. Identification of White Matter Hyperintensities in Routine Emergency Department Visits Using Portable Bedside Magnetic Resonance Imaging. Journal Of The American Heart Association 2023, 12: e029242. PMID: 37218590, PMCID: PMC10381997, DOI: 10.1161/jaha.122.029242.Peer-Reviewed Original ResearchConceptsWhite matter hyperintensitiesMagnetic resonance imagingSevere white matter hyperintensitiesConventional magnetic resonance imagingResonance imagingRetrospective cohortEmergency departmentMatter hyperintensitiesVascular risk factorsProspective observational studyVascular cognitive impairmentTesla magnetic resonance imagingArea Deprivation IndexProspective cohortAdult patientsAcute careRisk factorsCardiovascular diseaseObservational studyCognitive impairmentPatientsCare magnetic resonance imagingIntermodality agreementCohortDeprivation indexValidation of the rCAST score and comparison to the PCAC and FOUR scores for prognostication after out-of-hospital cardiac arrest
Kim N, Kitlen E, Garcia G, Khosla A, Miller P, Johnson J, Wira C, Greer D, Gilmore E, Beekman R. Validation of the rCAST score and comparison to the PCAC and FOUR scores for prognostication after out-of-hospital cardiac arrest. Resuscitation 2023, 188: 109832. PMID: 37178901, DOI: 10.1016/j.resuscitation.2023.109832.Peer-Reviewed Original ResearchConceptsPoor neurologic outcomeUnited States cohortHospital cardiac arrestOHCA patientsNeurologic outcomeCardiac arrestPost-cardiac arrest syndromePoor neurological outcomeScore predictive abilityHospital mortalityNeurological outcomeUnResponsiveness (FOUR) scorePoor outcomeRetrospective studyAccurate outcome predictionPrognostic performanceFull OutlineDeLong testOutcome predictionPatientsMortalityOutcomesScoresCohortPredictive abilityDiagnosis, Workup, Risk Reduction of Transient Ischemic Attack in the Emergency Department Setting: A Scientific Statement From the American Heart Association
Amin H, Madsen T, Bravata D, Wira C, Johnston S, Ashcraft S, Burrus T, Panagos P, Wintermark M, Esenwa C, Disease O. Diagnosis, Workup, Risk Reduction of Transient Ischemic Attack in the Emergency Department Setting: A Scientific Statement From the American Heart Association. Stroke 2023, 54: e109-e121. PMID: 36655570, DOI: 10.1161/str.0000000000000418.Peer-Reviewed Original ResearchConceptsTransient ischemic attackIschemic attackMaximal medical therapyHigh-risk patientsCorrect clinical diagnosisRisk stratification scaleAmerican Heart AssociationEmergency department settingFuture cerebrovascular eventsScientific statementTime of evaluationCerebrovascular eventsSecondary preventionStroke riskMedical therapyNeurological examinationAcute phaseIndex eventHeart AssociationDepartment settingPatient educationAncillary testingCerebral vasculatureConfirmatory testingClinical diagnosis
2021
Drip-and-ship versus mothership for endovascular treatment of acute stroke: A comparative effectiveness analysis
Wu X, Wira C, Matouk C, Forman H, Gandhi D, Sanelli P, Schindler J, Malhotra A. Drip-and-ship versus mothership for endovascular treatment of acute stroke: A comparative effectiveness analysis. International Journal Of Stroke 2021, 17: 315-322. PMID: 33759645, DOI: 10.1177/17474930211008701.Peer-Reviewed Original ResearchConceptsComprehensive stroke centerPrimary stroke centerAcute stroke patientsNearest comprehensive stroke centerAcute strokeMothership strategyStroke centersStroke patientsPlace of onsetHealth benefitsMarkov decision-analytic modelComparative effectiveness analysisRecent medical literatureMultiple sensitivity analysesDecision analytic modelMothership modelPrimary outcomeEndovascular treatmentPrehospital triageSudden onsetPatientsMedical literatureStrokeShip strategyTarget populationBlood Pressure Reductions in the Hyperacute Phase of Large Vessel Occlusion Ischemic Stroke Are Associated With Infarct Progression And Poor Functional Outcome (5141)
Peshwe K, Nguyen C, Kodali S, Kobsa J, Prasad A, Soto A, Wira C, Matouk C, Sheth K, Petersen N. Blood Pressure Reductions in the Hyperacute Phase of Large Vessel Occlusion Ischemic Stroke Are Associated With Infarct Progression And Poor Functional Outcome (5141). Neurology 2021, 96 DOI: 10.1212/wnl.96.15_supplement.5141.Peer-Reviewed Original Research
2020
Research Protocol and Case Report of Emergency Department Endovascular Aortic Occlusion (REBOA) in Non-traumatic Cardiac Arrest
Daley J, Cannon K, Buckley R, Aydin A, Latich I, Perez Lozada J, Bonz J, Joseph D, Coughlin R, Belsky J, Sather J, Wira C, Liu R, Johnson A, Moore C. Research Protocol and Case Report of Emergency Department Endovascular Aortic Occlusion (REBOA) in Non-traumatic Cardiac Arrest. Journal Of Endovascular Resuscitation And Trauma Management 2020, 4 DOI: 10.26676/jevtm.v40i(2).140.Peer-Reviewed Original ResearchMean arterial pressureEmergency departmentEmergency physiciansAortic occlusionCardiac arrestCase reportResearch protocolNon-traumatic cardiac arrestFeasibility of REBOAFavorable neurologic outcomeInitial casesNon-traumatic OHCAFemoral arterial accessHospital cardiac arrestTidal carbon dioxideEndovascular aortic occlusionEarly human studiesNeurologic outcomeSecondary outcomesArterial pressureInitial patientsPrimary outcomeSpontaneous circulationHemodynamic changesArterial accessA Research Protocol and Case Report of Emergency Department Endovascular Aortic Occlusion (REBOA) in Non-traumatic Cardiac Arrest
Daley J, Cannon K, Buckley R, Aydin A, Latich I, Lozada J, Bonz J, Joseph D, Coughlin R, Belsky J, Van Tonder R, Sather J, Wira C, Liu R, Johnson A, Moore C. A Research Protocol and Case Report of Emergency Department Endovascular Aortic Occlusion (REBOA) in Non-traumatic Cardiac Arrest. Journal Of Endovascular Resuscitation And Trauma Management 2020, 4: 88-93. DOI: 10.26676/jevtm.v4i2.140.Peer-Reviewed Original ResearchAdvanced cardiac life supportCardiac life supportEmergency departmentEmergency physiciansAortic occlusionCardiac arrestCase reportNon-traumatic cardiac arrestLife supportResuscitative endovascular balloon occlusionResearch protocolFeasibility of REBOAFavorable neurologic outcomeMean arterial pressureNon-traumatic OHCAFemoral arterial accessEndovascular balloon occlusionHospital cardiac arrestTidal carbon dioxideEndovascular aortic occlusionEarly human studiesNeurologic outcomeSecondary outcomesArterial pressureInitial patientsCrisis Resource Management and High-Performing Teams in Hyperacute Stroke Care
Rajendram P, Notario L, Reid C, Wira CR, Suarez JI, Weingart SD, Khosravani H. Crisis Resource Management and High-Performing Teams in Hyperacute Stroke Care. Neurocritical Care 2020, 33: 338-346. PMID: 32794144, PMCID: PMC7426067, DOI: 10.1007/s12028-020-01057-4.Peer-Reviewed Original ResearchStroke Code Presentations, Interventions, and Outcomes Before and During the COVID-19 Pandemic
Jasne AS, Chojecka P, Maran I, Mageid R, Eldokmak M, Zhang Q, Nystrom K, Vlieks K, Askenase M, Petersen N, Falcone GJ, Wira CR, Lleva P, Zeevi N, Narula R, Amin H, Navaratnam D, Loomis C, Hwang DY, Schindler J, Hebert R, Matouk C, Krumholz HM, Spudich S, Sheth KN, Sansing LH, Sharma R. Stroke Code Presentations, Interventions, and Outcomes Before and During the COVID-19 Pandemic. Stroke 2020, 51: 2664-2673. PMID: 32755347, PMCID: PMC7446978, DOI: 10.1161/str.0000000000000347.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBetacoronavirusBrain IschemiaCohort StudiesComorbidityConnecticutCoronary Artery DiseaseCoronavirus InfectionsCOVID-19DyslipidemiasEmergency Medical ServicesEthnicityFemaleHumansHypertensionIncomeInsurance, HealthIntracranial HemorrhagesMaleMedically UninsuredMiddle AgedOutcome and Process Assessment, Health CarePandemicsPneumonia, ViralRetrospective StudiesSARS-CoV-2Severity of Illness IndexStrokeSubstance-Related DisordersTelemedicineThrombectomyThrombolytic TherapyTime-to-TreatmentConceptsComprehensive stroke centerStroke codePatient characteristicsStroke severityStroke code patientsHistory of hypertensionStroke-like symptomsCoronary artery diseaseCoronavirus disease 2019 (COVID-19) pandemicPatient-level dataLower median household incomePublic health initiativesDisease 2019 pandemicCOVID-19 pandemicRace/ethnicityCode patientsHospital presentationPublic health insuranceRankin ScaleStroke centersArtery diseaseReperfusion timeStroke symptomsEarly outcomesConnecticut hospitalsPandemic Guidance for Stroke Centers Aiding COVID-19 Treatment Teams
Wira CR, Goyal M, Southerland AM, Sheth KN, McNair ND, Khosravani H, Leonard A, Panagos P, Council O. Pandemic Guidance for Stroke Centers Aiding COVID-19 Treatment Teams. Stroke 2020, 51: 10.1161/strokeaha.120.030749. PMID: 32716826, PMCID: PMC7326321, DOI: 10.1161/strokeaha.120.030749.Peer-Reviewed Original ResearchPrehospital Triage of Acute Stroke Patients During the COVID-19 Pandemic
Goyal M, Ospel JM, Southerland AM, Wira C, Amin-Hanjani S, Fraser JF, Panagos P, Committees O. Prehospital Triage of Acute Stroke Patients During the COVID-19 Pandemic. Stroke 2020, 51: 2263-2267. PMID: 32401680, DOI: 10.1161/strokeaha.120.030340.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAsymptomatic DiseasesBetacoronavirusCanadaCoronavirus InfectionsCOVID-19Delayed DiagnosisEmergency Medical ServicesEquipment ContaminationHealth WorkforceHumansInfectious Disease Transmission, Patient-to-ProfessionalInfectious Disease Transmission, Professional-to-PatientOccupational DiseasesPandemicsPneumonia, ViralProtective DevicesResource AllocationSARS-CoV-2StrokeSymptom AssessmentTime-to-TreatmentTransportation of PatientsTravelTriageUnconsciousnessWorkflowConceptsPatient triageAcute stroke patientsCoronavirus disease 2019 (COVID-19) pandemicEmergency medical services (EMS) providersDisease 2019 pandemicInfectious exposureStroke patientsPrehospital triageMedical service providersStatement paperPatientsTimely transferTriageCOVID-19COVID-19 pandemicHealthcare emergencyPandemicPortable, Bedside, Low-field Magnetic Resonance Imaging in an Intensive Care Setting for Intracranial Hemorrhage (270)
Shah J, Cahn B, By S, Welch E, Sacolick L, Yuen M, Mazurek M, Wira C, Leasure A, Matouk C, Ward A, Payabvash S, Beekman R, Brown S, Falcone G, Gobeske K, Petersen N, Jasne A, Sharma R, Schindler J, Sansing L, Gilmore E, Sze G, Rosen M, Kimberly W, Sheth K. Portable, Bedside, Low-field Magnetic Resonance Imaging in an Intensive Care Setting for Intracranial Hemorrhage (270). Neurology 2020, 94 DOI: 10.1212/wnl.94.15_supplement.270.Peer-Reviewed Original ResearchDeployment of Portable, Bedside, Low-field Magnetic Resonance Imaging for Evaluation of Stroke Patients (272)
Cahn B, Shah J, Dyvorne H, O’Halloran R, Poole M, Yuen M, Mazurek M, Ward A, Payabvash S, Beekman R, Brown S, Falcone G, Gobeske K, Petersen N, Jasne A, Sharma R, Schindler J, Sansing L, Gilmore E, Wira C, Matouk C, Sze G, Rosen M, Kimberly W, Sheth K. Deployment of Portable, Bedside, Low-field Magnetic Resonance Imaging for Evaluation of Stroke Patients (272). Neurology 2020, 94 DOI: 10.1212/wnl.94.15_supplement.272.Peer-Reviewed Original ResearchCharacterization of Blood Pressure Trajectories in the Hyperacute Phase of Large Vessel Occlusion Ischemic Stroke (4507)
Peshwe K, Nguyen C, Kodali S, Strander S, Kimmel A, Wang A, Matouk C, Sansing L, Sheth K, Wira C, Silverman A, Petersen N. Characterization of Blood Pressure Trajectories in the Hyperacute Phase of Large Vessel Occlusion Ischemic Stroke (4507). Neurology 2020, 94 DOI: 10.1212/wnl.94.15_supplement.4507.Peer-Reviewed Original Research