2021
Exploring the Unmet Need in Acute Ischemic Stroke Patients Not Treated With Intravenous Alteplase: The Get With The Guidelines‐Stroke Registry
Mac Grory B, Xian Y, Solomon N, Matsouaka R, Decker‐Palmer M, Fonarow G, Smith E, Schwamm L. Exploring the Unmet Need in Acute Ischemic Stroke Patients Not Treated With Intravenous Alteplase: The Get With The Guidelines‐Stroke Registry. Stroke Vascular And Interventional Neurology 2021, 2 DOI: 10.1161/svin.121.000226.Peer-Reviewed Original ResearchGuidelines-Stroke registryAcute ischemic strokeIschemic strokePatient populationCommon reasonUnmet needAcute ischemic stroke patientsIntravenous tissue plasminogen activatorAcute ischemic stroke careGuidelines-Stroke hospitalsIschemic stroke patientsIschemic stroke careLong-term outcomesTissue plasminogen activatorAlteplase deliveryHospital mortalityIntravenous alteplaseClinical characteristicsConclusions PatientsReadmission ratesEarly administrationPostdischarge costsStroke careStroke patientsFunctional outcomeIntegration of Regional Hospitalizations, Registry and Vital Statistics Data for Development of a Single Statewide Ischemic Stroke Database
Yan Z, Nielsen V, Song G, Christie A, Schwamm L, Zachrison K. Integration of Regional Hospitalizations, Registry and Vital Statistics Data for Development of a Single Statewide Ischemic Stroke Database. Journal Of Stroke And Cerebrovascular Diseases 2021, 31: 106236. PMID: 34954597, DOI: 10.1016/j.jstrokecerebrovasdis.2021.106236.Peer-Reviewed Original ResearchConceptsStroke databaseDetailed clinical variablesPopulation-based studyLong-term outcomesIndirect identifiersVital statistics databaseHospitalization registryStroke admissionsHospitalization databaseVital statistics dataTerm outcomesVital statusClinical variablesLarge-scale outcome researchClinical registryHospitalization recordsPatient variablesAdministrative databasesClinical dataRich clinical dataRegistryHospitalizationDeterministic linkageCumulative mortalityVital records
2020
Thrombolysis beyond 4.5 h in Acute Ischemic Stroke
Etherton M, Gadhia R, Schwamm L. Thrombolysis beyond 4.5 h in Acute Ischemic Stroke. Current Neurology And Neuroscience Reports 2020, 20: 35. PMID: 32607627, DOI: 10.1007/s11910-020-01055-1.Peer-Reviewed Original ResearchConceptsUnknown symptom onsetSymptom onsetAcute ischemic stroke patientsImproved long-term outcomesSalvageable brain tissueIntravenous thrombolytic therapyPlacebo-controlled trialAcute ischemic strokeIschemic stroke patientsLong-term outcomesDWI-FLAIR mismatchAlteplase treatmentSummaryIn patientsIschemic strokeStroke onsetAcute settingRecent FindingsIn recent yearsStroke patientsThrombolytic therapySalvageable tissueReviewThe purposeIndividualized approachStroke lesionsPatientsBrain tissueAssociation Between Thrombolytic Door-to-Needle Time and 1-Year Mortality and Readmission in Patients With Acute Ischemic Stroke
Man S, Xian Y, Holmes D, Matsouaka R, Saver J, Smith E, Bhatt D, Schwamm L, Fonarow G. Association Between Thrombolytic Door-to-Needle Time and 1-Year Mortality and Readmission in Patients With Acute Ischemic Stroke. JAMA 2020, 323: 2170-2184. PMID: 32484532, PMCID: PMC7267850, DOI: 10.1001/jama.2020.5697.Peer-Reviewed Original ResearchConceptsIntravenous tissue plasminogen activatorAcute ischemic strokeTissue plasminogen activatorCause mortalityNeedle timeCause readmissionIschemic strokeLong-term outcomesShorter doorBetter long-term outcomesImproved long-term outcomesPlasminogen activatorRetrospective cohort studyGood functional outcomeGuidelines-StrokeCohort studyHospital arrivalHospital dischargeMedian doorEarly administrationMedian agePrimary outcomeThrombolytic therapyFunctional outcomeReadmission
2019
Clinical Effectiveness of Direct Oral Anticoagulants vs Warfarin in Older Patients With Atrial Fibrillation and Ischemic Stroke
Xian Y, Xu H, O’Brien E, Shah S, Thomas L, Pencina M, Fonarow G, Olson D, Schwamm L, Bhatt D, Smith E, Hannah D, Maisch L, Lytle B, Peterson E, Hernandez A. Clinical Effectiveness of Direct Oral Anticoagulants vs Warfarin in Older Patients With Atrial Fibrillation and Ischemic Stroke. JAMA Neurology 2019, 76: 1192-1202. PMID: 31329212, PMCID: PMC6647003, DOI: 10.1001/jamaneurol.2019.2099.Peer-Reviewed Original ResearchDirect oral anticoagulantsAcute ischemic strokeMajor adverse cardiovascular eventsAdverse cardiovascular eventsIschemic strokeLong-term outcomesAtrial fibrillationCardiovascular eventsOral anticoagulantsClinical effectivenessHigh riskHealth Stroke Scale scoreBetter long-term outcomesFirst year postdischargeStroke Scale scorePatient-centered outcomesPatient-centered measuresDOAC useGuidelines-StrokeCardiovascular readmissionCause readmissionGastrointestinal bleedingStroke preventionWarfarin prescriptionBaseline characteristicsThe Mild and Rapidly Improving Stroke Study (MaRISS): Rationale and design
Romano J, Gardener H, Campo-Bustillo I, Khan Y, Riley N, Tai S, Sacco R, Khatri P, Smith E, Schwamm L. The Mild and Rapidly Improving Stroke Study (MaRISS): Rationale and design. International Journal Of Stroke 2019, 14: 983-986. PMID: 31496438, DOI: 10.1177/1747493019873595.Peer-Reviewed Original ResearchConceptsStroke symptomsStroke Impact Scale-16Actual treatment ratesMild ischemic strokePrimary safety outcomeSymptomatic hemorrhagic transformationProportion of patientsThird of patientsProspective observational studyEffect of alteplaseAcute stroke trialsLong-term outcomesPredictors of outcomeAlteplase treatmentHemorrhagic transformationIschemic strokeRankin ScaleSecondary outcomesBarthel IndexPrimary outcomeResidual disabilityStroke presentationRetrospective studyStroke StudyStroke trials
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 InstituteEffect of a Multifaceted Quality Improvement Intervention on Hospital Personnel Adherence to Performance Measures in Patients With Acute Ischemic Stroke in China: A Randomized Clinical Trial
Wang Y, Li Z, Zhao X, Wang C, Wang X, Wang D, Liang L, Liu L, Wang C, Li H, Shen H, Bettger J, Pan Y, Jiang Y, Yang X, Zhang C, Han X, Meng X, Yang X, Kang H, Yuan W, Fonarow G, Peterson E, Schwamm L, Xian Y, Wang Y. Effect of a Multifaceted Quality Improvement Intervention on Hospital Personnel Adherence to Performance Measures in Patients With Acute Ischemic Stroke in China: A Randomized Clinical Trial. JAMA 2018, 320: 245-254. PMID: 29959443, DOI: 10.1001/jama.2018.8802.Peer-Reviewed Original ResearchConceptsMultifaceted quality improvement interventionAcute ischemic strokeQuality improvement interventionsEvidence-based performance measuresIschemic strokeImprovement interventionsControl groupUsual careClinical trialsIntervention groupEvidence-based stroke careCluster-randomized clinical trialClinical vascular eventsCo-primary outcomesLong-term outcomesHospital mortalityStroke RegistryVascular eventsSecondary outcomesPrimary outcomeStroke careCare protocolsClinical pathwayMAIN OUTCOMEPatientsDiabetes and long-term outcomes of ischaemic stroke: findings from Get With The Guidelines-Stroke
Echouffo-Tcheugui J, Xu H, Matsouaka R, Xian Y, Schwamm L, Smith E, Bhatt D, Hernandez A, Heidenreich P, Fonarow G. Diabetes and long-term outcomes of ischaemic stroke: findings from Get With The Guidelines-Stroke. European Heart Journal 2018, 39: 2376-2386. PMID: 29438515, PMCID: PMC6031049, DOI: 10.1093/eurheartj/ehy036.Peer-Reviewed Original ResearchConceptsComposite of mortalityNon-cardiovascular hospitalizationsTransient ischemic attackLong-term outcomesIschemic strokeHeart failureGuidelines-StrokeCause readmissionIS/transient ischemic attackHealth Stroke ScaleInfluence of diabetesRisk of deathOutcomes of interestPaucity of dataIschemic attackMore comorbiditiesTIA recurrenceCardiovascular readmissionCause mortalityHF readmissionStroke ScalePatient's diabetesAdverse outcomesInitial severityReadmission
2013
Racial and Ethnic Differences in Outcomes in Older Patients With Acute Ischemic Stroke
Qian F, Fonarow G, Smith E, Xian Y, Pan W, Hannan E, Shaw B, Glance L, Peterson E, Eapen Z, Hernandez A, Schwamm L, Bhatt D. Racial and Ethnic Differences in Outcomes in Older Patients With Acute Ischemic Stroke. Circulation Cardiovascular Quality And Outcomes 2013, 6: 284-292. PMID: 23680966, DOI: 10.1161/circoutcomes.113.000211.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overBlack or African AmericanBrain IschemiaEthnicityFemaleHealth Status DisparitiesHealthcare DisparitiesHispanic or LatinoHumansLogistic ModelsMaleMedicareMultivariate AnalysisOdds RatioPatient ReadmissionRacial GroupsRegistriesRisk FactorsSeverity of Illness IndexStrokeTime FactorsTreatment OutcomeUnited StatesWhite PeopleConceptsAcute ischemic strokeLong-term outcomesRace/ethnicityCause rehospitalizationOlder patientsIschemic strokeUnadjusted mortalityHispanic patientsGuidelines-Stroke programGuidelines-Stroke registryHealth Stroke ScaleOlder Medicare beneficiariesAmerican Heart AssociationAsian American patientsYears of ageStroke ScaleStroke severityHigher median scoresAsian patientsHeart AssociationHospital characteristicsAmerican patientsUS CentersPrognostic variablesLower odds