2022
Association Between Endovascular Therapy Time to Treatment and Outcomes in Patients With Basilar Artery Occlusion
Joundi R, Sun J, Xian Y, Alhanti B, Nogueira R, Bhatt D, Fonarow G, Saver J, Schwamm L, Smith E. Association Between Endovascular Therapy Time to Treatment and Outcomes in Patients With Basilar Artery Occlusion. Circulation 2022, 145: 896-905. PMID: 35050693, DOI: 10.1161/circulationaha.121.056554.Peer-Reviewed Original ResearchConceptsBasilar artery occlusionSymptomatic intracranial hemorrhageEndovascular therapySymptom onsetEVT timesHospital mortalityArtery occlusionMedian onsetIntracranial hemorrhageBetter outcomesHealth Stroke Scale scoreIndividual-level patient dataMedian National InstitutesStroke Scale scoreHospital-level factorsProportion of patientsLogistic regression modelsSubstantial reperfusionAnterior circulationPrimary outcomeUS registryMean ageDevastating conditionImproved outcomesTherapy time
2021
Association Between Hospital Volumes and Clinical Outcomes for Patients With Nontraumatic Subarachnoid Hemorrhage
Leifer D, Fonarow G, Hellkamp A, Baker D, Hoh B, Prabhakaran S, Schoeberl M, Suter R, Washington C, Williams S, Xian Y, Schwamm L. Association Between Hospital Volumes and Clinical Outcomes for Patients With Nontraumatic Subarachnoid Hemorrhage. Journal Of The American Heart Association 2021, 10: e018373. PMID: 34325522, PMCID: PMC8475679, DOI: 10.1161/jaha.120.018373.Peer-Reviewed Original ResearchConceptsAnnual case volumeComprehensive Stroke Center (CSC) certificationStroke center certificationNational Inpatient SampleSubarachnoid hemorrhageNontraumatic subarachnoid hemorrhageCase volumeHospital mortalityClinical outcomesPoor outcomeCenter certificationSAH casesBetter outcomesVolume thresholdHospital annual case volumeHospital case volumeCases/yearBackground Previous studiesLogistic regression modelsSAH hospitalizationsHospital volumeAneurysm obliterationInpatient SampleOdds ratioImproved outcomes
2018
Evidence-Based Performance Measures and Outcomes in Patients With Acute Ischemic Stroke
Wang Y, Li Z, Zhao X, Liu L, Wang C, Wang C, Peterson E, Schwamm L, Fonarow G, Smith S, Bettger J, Wang D, Li H, Xian Y, Wang Y. Evidence-Based Performance Measures and Outcomes in Patients With Acute Ischemic Stroke. Circulation Cardiovascular Quality And Outcomes 2018, 11: e001968. PMID: 30557048, DOI: 10.1161/circoutcomes.115.001968.Peer-Reviewed Original ResearchMeSH KeywordsAgedBrain IschemiaChinaClinical CompetenceDisability EvaluationEvidence-Based MedicineFemaleFibrinolytic AgentsGuideline AdherenceHumansMaleMiddle AgedOutcome and Process Assessment, Health CarePractice Guidelines as TopicPractice Patterns, Physicians'Prospective StudiesQuality ImprovementQuality Indicators, Health CareRecovery of FunctionRegistriesRisk FactorsSmoking CessationStrokeStroke RehabilitationThrombolytic TherapyTime FactorsTime-to-TreatmentTreatment OutcomeConceptsAcute ischemic strokeIschemic strokeOptimal complianceStroke careChina National Stroke RegistryEvidence-based performance measuresMultivariable Cox modelNational Stroke RegistryFavorable functional outcomeProspective cohort studyEvidence-based guidelinesRoutine clinical practiceCause of deathIntravenous tPAStroke recurrenceStroke RegistryCohort studyNationwide registryClinical outcomesFunctional outcomeCare measuresImproved outcomesHospital measuresCox modelClinical practice
2017
Frequent Hub–Spoke Contact Is Associated with Improved Spoke Hospital Performance: Results from the Massachusetts General Hospital Telestroke Network
Moreno A, Schwamm L, Siddiqui K, Viswanathan A, Whitney C, Rost N, Zachrison K. Frequent Hub–Spoke Contact Is Associated with Improved Spoke Hospital Performance: Results from the Massachusetts General Hospital Telestroke Network. Telemedicine Journal And E-Health 2017, 24: 678-683. PMID: 29271703, PMCID: PMC6014912, DOI: 10.1089/tmj.2017.0252.Peer-Reviewed Original ResearchConceptsDTN timePatient presentationTelestroke consultsTelestroke networkPatient-level regression analysesAcute ischemic stroke patientsShorter DTN timesIschemic stroke patientsFrequent contactPrimary predictor variableMedian DTNTPA administrationNeedle timeTPA useSpoke hospitalsStroke patientsMore frequent contactsHub hospitalImproved outcomesMedian numberTPA deliveryPatientsHospitalRegression analysisTelestroke
2014
Hospital Case Volume Is Associated With Mortality in Patients Hospitalized With Subarachnoid Hemorrhage
Prabhakaran S, Fonarow G, Smith E, Liang L, Xian Y, Neely M, Peterson E, Schwamm L. Hospital Case Volume Is Associated With Mortality in Patients Hospitalized With Subarachnoid Hemorrhage. Neurosurgery 2014, 75: 500-508. PMID: 24979097, DOI: 10.1227/neu.0000000000000475.Peer-Reviewed Original ResearchConceptsHospital case volumeHospital mortalitySubarachnoid hemorrhageCase volumeSAH volumeSAH patientsHospital characteristicsMedian annual case volumeGuidelines-Stroke registryLarge nationwide registryMultivariable logistic regressionLength of stayAnnual case volumeContemporary national dataIndependent ambulatory statusAmbulatory statusExperienced centersNationwide registryDischarge diagnosisOptimized careImproved outcomesRelevant patientsPatientsHospitalMortality
2012
Telestroke increases use of acute stroke therapy
Müller-Barna P, Schwamm L, Haberl R. Telestroke increases use of acute stroke therapy. Current Opinion In Neurology 2012, 25: 5-10. PMID: 22157105, DOI: 10.1097/wco.0b013e32834d5fe4.Peer-Reviewed Original ResearchConceptsTelestroke networkStroke careUsage of guidelinesAcute stroke careAcute stroke therapyIschemic stroke patientsRate of thrombolysisNew therapeutic modalitiesStroke teamAcute strokeNeurological examinationStroke unitStroke patientsStroke therapyStroke managementImproved outcomesTherapeutic modalitiesTelestroke servicesRemote reviewUnderserved areasHigh-quality videoconferencingCareIncrease useRegular basisThrombolysis
2011
A Qualitative Assessment of Practices Associated With Shorter Door-to-Needle Time for Thrombolytic Therapy in Acute Ischemic Stroke
Olson D, Constable M, Britz G, Lin C, Zimmer L, Schwamm L, Fonarow G, Peterson E. A Qualitative Assessment of Practices Associated With Shorter Door-to-Needle Time for Thrombolytic Therapy in Acute Ischemic Stroke. Journal Of Neuroscience Nursing 2011, 43: 329-336. PMID: 22089410, DOI: 10.1097/jnn.0b013e318234e7fb.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeNeedle timeIschemic strokeStroke patientsGoal of doorQualitative telephone interviewsThrombolytic therapyEarly treatmentImproved outcomesTPA deliveryRapid triageHermeneutic phenomenological frameworkTelephone interviewsPatientsU.S. hospitalsStrokeHospitalFaster treatmentTreatmentNovel factorOvercoming barriersElicit strategiesAlteplaseQualitative assessmentTherapy