2024
Evaluating the concordance between International Classification of Diseases, Tenth Revision Code and stroke severity as measured by the National Institutes of Health Stroke Scale
Taha M, Habib M, Lomachinsky V, Hadar P, Newhouse J, Schwamm L, Blacker D, Moura L. Evaluating the concordance between International Classification of Diseases, Tenth Revision Code and stroke severity as measured by the National Institutes of Health Stroke Scale. BMJ Neurology Open 2024, 6: e000831. PMID: 39363950, PMCID: PMC11448239, DOI: 10.1136/bmjno-2024-000831.Peer-Reviewed Original ResearchPaul Coverdell National Acute Stroke ProgramNational Institutes of Health Stroke ScaleInternational Classification of DiseasesClassification of DiseasesHealth Stroke ScaleInternational ClassificationICD-10Acute ischaemic strokeStroke severityICD-10 diagnosis codesStroke ScaleNIHSS scoreMeasures of stroke severityMedicare claims dataIntraclass correlation coefficientNational Institutes of Health Stroke Scale scoreNational InstituteMedicaid Services guidelinesService guidelinesStroke programClinical registryDiagnosis codesClaims dataSampled patientsExpert clinical evaluation
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 InstituteSeverity
2019
Frequency of early rapid improvement in stroke severity during interfacility transfer.
Zachrison K, Leslie-Mazwi T, Boulouis G, Goldstein J, Regenhardt R, Viswanathan A, Lauer A, Siddiqui K, Charidimou A, Rost N, Schwamm L. Frequency of early rapid improvement in stroke severity during interfacility transfer. Neurology Clinical Practice 2019, 9: 373-380. PMID: 31750022, PMCID: PMC6814428, DOI: 10.1212/cpj.0000000000000667.Peer-Reviewed Original ResearchNIHSS scoreInterfacility transferMedian initial NIHSS scoreNIH Stroke Scale scoreHigher initial NIHSSInitial NIHSS scoreNIHSS score changeStroke Scale scoreRapid improvementCSC arrivalInitial NIHSSIndex strokeStroke severityPatient characteristicsMedian changeMultivariable modelingScale scoreScore changeLogistic regressionStrokePatientsScoresDEFUSE 3 Non-DAWN Patients
Leslie-Mazwi T, Hamilton S, Mlynash M, Patel A, Schwamm L, Lansberg M, Marks M, Hirsch J, Albers G. DEFUSE 3 Non-DAWN Patients. Stroke 2019, 50: 618-625. PMID: 30727856, PMCID: PMC6768068, DOI: 10.1161/strokeaha.118.023310.Peer-Reviewed Original ResearchConceptsRankin Scale scoreNIHSS 6DEFUSE 3Functional outcomeInfarct volumeLarger patientsDAWN criteriaScale scoreEmergent large vessel occlusionRankin Scale score 0DEFUSE 3 patientsEffect of thrombectomyHealth Stroke ScaleLarge vessel occlusionBenefit of thrombectomyCore infarct volumeBeneficial treatment effectMethods Eligibility criteriaNIHSS scoreStroke ScaleConclusions PatientsEndovascular therapySymptom onsetDAWN trialVessel occlusion
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 documentation
2014
Combining MRI with NIHSS Thresholds to Predict Outcome in Acute Ischemic Stroke: Value for Patient Selection
Schaefer P, Pulli B, Copen W, Hirsch J, Leslie-Mazwi T, Schwamm L, Wu O, González R, Yoo A. Combining MRI with NIHSS Thresholds to Predict Outcome in Acute Ischemic Stroke: Value for Patient Selection. American Journal Of Neuroradiology 2014, 36: 259-264. PMID: 25258369, PMCID: PMC4462135, DOI: 10.3174/ajnr.a4103.Peer-Reviewed Original ResearchMeSH KeywordsAgedBrainBrain IschemiaCerebral InfarctionDiffusion Magnetic Resonance ImagingFemaleHumansImage Processing, Computer-AssistedMaleMiddle AgedNational Institutes of Health (U.S.)Patient SelectionPrognosisReperfusionROC CurveSensitivity and SpecificitySeverity of Illness IndexStrokeUnited StatesConceptsPositive predictive valueAcute ischemic strokeLarge patient cohortReperfusion therapyPoor outcomeStroke sidePredictive valueNIHSS scoreIschemic strokeClinical outcomesPatient cohortPrognostic yieldAnterior circulation acute ischemic strokeAcute ischemic stroke patientsImaging thresholdsBeneficial treatment responseDiffusion-perfusion mismatchHigh positive predictive valueIschemic stroke patientsRight-sided strokeLeft-sided strokeUntreated patientsStroke onsetConsecutive patientsPatient selection
2013
Dysphagia Screening and Hospital-acquired Pneumonia in Patients with Acute Ischemic Stroke: Findings from Get with the Guidelines–Stroke
Masrur S, Smith E, Saver J, Reeves M, Bhatt D, Zhao X, Olson D, Pan W, Hernandez A, Fonarow G, Schwamm L. Dysphagia Screening and Hospital-acquired Pneumonia in Patients with Acute Ischemic Stroke: Findings from Get with the Guidelines–Stroke. Journal Of Stroke And Cerebrovascular Diseases 2013, 22: e301-e309. PMID: 23305674, DOI: 10.1016/j.jstrokecerebrovasdis.2012.11.013.Peer-Reviewed Original ResearchConceptsHospital-acquired pneumoniaDysphagia screeningStroke patientsGuidelines-StrokeNIHSS scoreIschemic strokeOral intakeMultivariable analysisHealth Stroke Scale scoreAdmission National InstitutesGuidelines-Stroke hospitalsStroke Scale scoreAcute ischemic strokeIschemic stroke patientsLength of stayEligible patientsHospital mortalitySevere strokeFemale genderNational guidelinesLower riskPatientsScale scorePneumoniaStroke
2012
Comparison of 30-Day Mortality Models for Profiling Hospital Performance in Acute Ischemic Stroke With vs Without Adjustment for Stroke Severity
Fonarow G, Pan W, Saver J, Smith E, Reeves M, Broderick J, Kleindorfer D, Sacco R, Olson D, Hernandez A, Peterson E, Schwamm L. Comparison of 30-Day Mortality Models for Profiling Hospital Performance in Acute Ischemic Stroke With vs Without Adjustment for Stroke Severity. JAMA 2012, 308: 257-264. PMID: 22797643, DOI: 10.1001/jama.2012.7870.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeNIHSS scoreInitial stroke severityIschemic strokeStroke severityMedicare beneficiariesClaims-based risk modelsHospital mortality modelMean NIHSS scoreRisk-standardized outcomesHealth Stroke ScaleNet reclassification improvementDiscrimination improvement indexService Medicare beneficiariesHospital mortality risk modelMortality risk modelProfiling Hospital PerformanceGuidelines-StrokeIndex hospitalizationStroke ScaleReclassification improvementRisk modelModel discriminationPotential eligibilityStudy populationRelationship 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. PMID: 23130117, PMCID: PMC3487316, DOI: 10.1161/jaha.111.000034.Peer-Reviewed Original ResearchAcute ischemic strokeHealth Stroke ScaleIschemic strokeMedicare beneficiariesNIHSS scoreStroke ScaleStroke severityMortality riskMortality rateGuidelines-Stroke hospitalsMedian NIHSS scoreSubstantial prognostic informationInitial stroke severityDiscrimination of riskService Medicare beneficiariesNational InstituteContinuous variablesMean ageC-statisticPrognostic informationRisk discriminationNIHSSClinical informationGraded relationStroke
2010
Risk Score for In-Hospital Ischemic Stroke Mortality Derived and Validated Within the Get With The Guidelines–Stroke Program
Smith E, Shobha N, Dai D, Olson D, Reeves M, Saver J, Hernandez A, Peterson E, Fonarow G, Schwamm L. Risk Score for In-Hospital Ischemic Stroke Mortality Derived and Validated Within the Get With The Guidelines–Stroke Program. Circulation 2010, 122: 1496-1504. PMID: 20876438, DOI: 10.1161/circulationaha.109.932822.Peer-Reviewed Original ResearchConceptsShort-term mortality riskIschemic stroke mortalityNIHSS scoreHospital mortalityC-statisticStroke mortalityPatients' short-term mortality riskHealth Stroke Scale scoreGuidelines-Stroke programHistory of dyslipidemiaValidate prediction modelsMortality risk stratificationStroke Scale scoreIschemic stroke patientsPeripheral vascular diseasePrevious myocardial infarctionPractical bedside toolValidation sampleCurrent smokingIschemic strokeDiabetes mellitusIndependent predictorsPrevious strokeRisk stratificationAtrial fibrillationCombining Acute Diffusion-Weighted Imaging and Mean Transmit Time Lesion Volumes With National Institutes of Health Stroke Scale Score Improves the Prediction of Acute Stroke Outcome
Yoo A, Barak E, Copen W, Kamalian S, Gharai L, Pervez M, Schwamm L, González R, Schaefer P. Combining Acute Diffusion-Weighted Imaging and Mean Transmit Time Lesion Volumes With National Institutes of Health Stroke Scale Score Improves the Prediction of Acute Stroke Outcome. Stroke 2010, 41: 1728-1735. PMID: 20595665, DOI: 10.1161/strokeaha.110.582874.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overBrainBrain IschemiaDiffusion Magnetic Resonance ImagingFemaleHumansImage Processing, Computer-AssistedMaleMiddle AgedNational Institutes of Health (U.S.)Predictive Value of TestsPrognosisROC CurveSeverity of Illness IndexStatistics, NonparametricStrokeTime FactorsTreatment OutcomeUnited StatesConceptsAcute diffusion-weighted imagingDiffusion-weighted imagingAcute ischemic strokeNIHSS scorePoor outcomeLesion volumeIschemic strokeRankin ScaleBetter outcomesHealth Stroke Scale scoreAcute stroke outcomeDWI lesion volumeBaseline NIHSS scoreHealth Stroke ScaleStroke Scale scoreLower NIHSS scoreModified Rankin ScaleNational InstituteQuantitative diffusion-weighted imagingMTT volumesStroke ScaleStroke outcomeSymptom onsetClinical outcomesPrognostic yield
2008
Intravenous desmoteplase in patients with acute ischaemic stroke selected by MRI perfusion–diffusion weighted imaging or perfusion CT (DIAS-2): a prospective, randomised, double-blind, placebo-controlled study
Hacke W, Furlan A, Al-Rawi Y, Davalos A, Fiebach J, Gruber F, Kaste M, Lipka L, Pedraza S, Ringleb P, Rowley H, Schneider D, Schwamm L, Leal J, Söhngen M, Teal P, Wilhelm-Ogunbiyi K, Wintermark M, Warach S. Intravenous desmoteplase in patients with acute ischaemic stroke selected by MRI perfusion–diffusion weighted imaging or perfusion CT (DIAS-2): a prospective, randomised, double-blind, placebo-controlled study. The Lancet Neurology 2008, 8: 141-150. PMID: 19097942, PMCID: PMC2730486, DOI: 10.1016/s1474-4422(08)70267-9.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overBrain IschemiaCerebral HemorrhageDouble-Blind MethodFemaleFibrinolytic AgentsHumansInjections, IntravenousMagnetic Resonance ImagingMaleMiddle AgedPerfusionPlasminogen ActivatorsProspective StudiesSample SizeStrokeTomography, X-Ray ComputedTreatment FailureYoung AdultConceptsSymptomatic intracranial hemorrhageClinical response rateAcute ischemic strokeDiffusion-weighted imagingResponse rateNIHSS scoreIschemic strokeIntracranial hemorrhageLesion volumeDay 90Mortality ratePerfusion imagingScale scoreHealth Stroke Scale scoreMedian baseline NIHSS scoreModified Rankin Scale scoreMagnetic resonance perfusion imagingComposite of improvementBaseline NIHSS scorePlacebo-controlled studyStroke Scale scoreDose-ranging studyRankin Scale scoreSymptoms of strokeOnset of strokeRole of Recanalization in Acute Stroke Outcome: Rationale for a CT Angiogram-Based “Benefit of Recanalization” Model
Rosenthal E, Schwamm L, Roccatagliata L, Coutts S, Demchuk A, Schaefer P, Gonzalez R, Hill M, Halpern E, Lev M. Role of Recanalization in Acute Stroke Outcome: Rationale for a CT Angiogram-Based “Benefit of Recanalization” Model. American Journal Of Neuroradiology 2008, 29: 1471-1475. PMID: 18599577, PMCID: PMC8119059, DOI: 10.3174/ajnr.a1153.Peer-Reviewed Original ResearchConceptsOnly independent predictorLesion volumeComplete recanalizationRecanalization statusClinical outcomesNIHSS scoreIndependent predictorsIncomplete recanalizationCTA-SI Alberta Stroke Program Early CT ScoreAcute middle cerebral artery strokeAlberta Stroke Program Early CT ScoreHealth Stroke Scale scoreMedian admission NIHSS scoreMiddle cerebral artery strokeCT angiographic source imagesAcute stroke outcomeAdmission National InstitutesBenefit of recanalizationEarly successful recanalizationMCA M1 occlusionRole of recanalizationStroke Scale scoreAdmission NIHSS scoreMRS score 0CT/CTA
2001
CT Angiography Use in Acute Stroke Patients Undergoing i.v. TPA
Rordorf G, Koroshetz W, Buonanno F, McDonald C, Greer D, Ougorets I, Rosand J, Schwamm L. CT Angiography Use in Acute Stroke Patients Undergoing i.v. TPA. Stroke 2001, 32: 370-370. DOI: 10.1161/str.32.suppl_1.370-a.Peer-Reviewed Original ResearchRt-PACT angiographyInitial head CT scanAsymptomatic intracranial hemorrhageInitial NIHSS scoreMajor vessel occlusionStroke Study GroupAcute ischemic strokeAcute stroke patientsRisk of hemorrhageSubgroup of patientsHead CT scanChances of recanalizationMajor intracranial arteriesHelical CT angiographyNIHSS scoreNINDS criteriaLacunar strokeOcclusive lesionsStroke teamSystemic complicationsTOAST criteriaAnterior circulationDistal emboliIschemic stroke
1999
Role for Telemedicine in Acute Stroke
Shafqat S, Kvedar J, Guanci M, Chang Y, Schwamm L. Role for Telemedicine in Acute Stroke. Stroke 1999, 30: 2141-2145. PMID: 10512919, DOI: 10.1161/01.str.30.10.2141.Peer-Reviewed Original ResearchConceptsNIH Stroke ScaleNIHSS scoreStroke neurologistsStroke ScaleAcute strokePatient's bedsideAcute stroke assessmentTotal NIHSS scoreAcute stroke treatmentEvaluation of patientsReliable clinical instrumentIschemic strokeStroke treatmentClinical outcomesStroke specialistsStroke expertiseBedside examinationStroke assessmentBedside assessmentKappa coefficientTelemedicine linkPatientsBedsideClinical instrumentsStroke