2024
Thrombolysis for Wake-Up Stroke Versus Non–Wake-Up Unwitnessed Stroke: EOS Individual Patient Data Meta-Analysis
Kamogawa N, Miwa K, Toyoda K, Jensen M, Inoue M, Yoshimura S, Fukuda-Doi M, Kitazono T, Boutitie F, Ma H, Ringleb P, Wu O, Schwamm L, Warach S, Hacke W, Davis S, Donnan G, Gerloff C, Thomalla G, Koga M, Investigators O. Thrombolysis for Wake-Up Stroke Versus Non–Wake-Up Unwitnessed Stroke: EOS Individual Patient Data Meta-Analysis. Stroke 2024, 55: 895-904. PMID: 38456303, PMCID: PMC10978262, DOI: 10.1161/strokeaha.123.043358.Peer-Reviewed Original ResearchConceptsSymptomatic intracranial hemorrhageIntracranial hemorrhageIntravenous thrombolysisFavorable outcomeUnwitnessed strokeNon-WUSFrequency of favorable outcomesIndividual patient-data meta-analysisMultivariate logistic regression analysisModified Rankin Scale scoreSafety of intravenous thrombolysisRankin Scale scoreEffect of intravenous thrombolysisIntravenous thrombolysis groupLogistic regression analysisUnknown-onset strokeRandomized controlled trialsNo significant differencePatient-level dataData meta-analysisStandard treatmentInsufficient statistical powerPatientsSafety outcomesControlled trialsCOVID‐19 Infection Is Associated With Poor Outcomes in Patients With Intracerebral Hemorrhage
Renedo D, Leasure A, Young R, Rivier C, Alhanti B, Mac Grory B, Messe S, Reeves M, Hassan A, Schwamm L, de Havenon A, Matouk C, Sheth K, Falcone G. COVID‐19 Infection Is Associated With Poor Outcomes in Patients With Intracerebral Hemorrhage. Journal Of The American Heart Association 2024, 13: e030999. PMID: 38293940, PMCID: PMC11056169, DOI: 10.1161/jaha.123.030999.Peer-Reviewed Original ResearchConceptsOdds of poor outcomeIntracerebral hemorrhageCOVID-19 infectionPoor outcomeHealth care deliverySkilled nursing facilityMultivariate analysisOdds of mortalityConcomitant COVID-19 infectionAssociated with poor outcomesCare deliveryNursing facilitiesPoor functional outcomeCOVID-19OddsICH outcomeImpact of COVID-19No significant differenceObservational studyHemorrhagic strokeWorsen outcomesPatient populationFunctional outcomesStroke dataPatients
2023
Hospital‐Level Variability in Reporting of Ischemic Stroke Subtypes and Supporting Diagnostic Evaluation in GWTG‐Stroke Registry
Mullen M, Gurol M, Prabhakaran S, Messé S, Kleindorfer D, Smith E, Fonarow G, Xu H, Zhao X, Cigarroa J, Schwamm L. Hospital‐Level Variability in Reporting of Ischemic Stroke Subtypes and Supporting Diagnostic Evaluation in GWTG‐Stroke Registry. Journal Of The American Heart Association 2023, 12: e031303. PMID: 38108258, PMCID: PMC10863791, DOI: 10.1161/jaha.123.031303.Peer-Reviewed Original ResearchConceptsHospital-level variabilityDiagnostic evaluationIschemic strokeDiagnostic testingStroke pathogenesisCryptogenic strokeSecondary preventionEtiologic subtypesRisk factorsLarge nationwide registryIschemic stroke subtypesLong-term cardiac rhythm monitoringCardiac rhythm monitoringAdequate diagnostic evaluationIntracranial vascular imagingEvidence-based interventionsNationwide registryStroke subtypesIS subtypesDocumentation ratesRhythm monitoringPatientsCardiac monitoringSubtypesStrokeEffects of Remote Patient Monitoring Use on Care Outcomes Among Medicare Patients With Hypertension : An Observational Study.
Tang M, Nakamoto C, Stern A, Zubizarreta J, Marcondes F, Uscher-Pines L, Schwamm L, Mehrotra A. Effects of Remote Patient Monitoring Use on Care Outcomes Among Medicare Patients With Hypertension : An Observational Study. Annals Of Internal Medicine 2023, 176: 1465-1475. PMID: 37931262, DOI: 10.7326/m23-1182.Peer-Reviewed Original ResearchConceptsObservational studyCare outcomesRemote patient monitoringAcute care encountersHypertension medication usePhysician outpatient visitsAcute care useChronic disease managementReceipt of careBlood pressure dataHypertension careUnique medicationsMedication usePrimary outcomeOutpatient visitsResidual confoundingCare useMedication fillsDays' supplyMedicare patientsCare encountersControl practicesHypertensionPatientsImaging useMost Promising Approaches to Improve Stroke Outcomes: The Stroke Treatment Academic Industry Roundtable XII Workshop
Wechsler L, Adeoye O, Alemseged F, Bahr-Hosseini M, Deljkich E, Favilla C, Fisher M, Grotta J, Hill M, Kamel H, Khatri P, Lyden P, Mirza M, Nguyen T, Samaniego E, Schwamm L, Selim M, Silva G, Yavagal D, Yenari M, Zachrison K, Boltze J, Yaghi S, Roundtable O. Most Promising Approaches to Improve Stroke Outcomes: The Stroke Treatment Academic Industry Roundtable XII Workshop. Stroke 2023, 54: 3202-3213. PMID: 37886850, DOI: 10.1161/strokeaha.123.044279.Peer-Reviewed Original ResearchInsurance-Based Disparities in Stroke Center Access in California: A Network Science Approach
Zachrison K, Hsia R, Schwamm L, Yan Z, Samuels-Kalow M, Reeves M, Camargo C, Onnela J. Insurance-Based Disparities in Stroke Center Access in California: A Network Science Approach. Circulation Cardiovascular Quality And Outcomes 2023, 16: e009868. PMID: 37746725, PMCID: PMC10592016, DOI: 10.1161/circoutcomes.122.009868.Peer-Reviewed Original ResearchConceptsInsurance-based disparitiesStroke centersEmergency departmentHospital clustersInitial emergency departmentIschemic stroke admissionsHospital emergency departmentClusters of hospitalsLogistic regression modelsStroke admissionsUninsured patientsPatient insuranceLower oddsPatientsLess strokeCenter accessOddsCenter transferHospitalLikelihood of transferInsurance groupsRegression modelsLower proportionDepartmentAssociationFactors Associated with the Digital Patient Experience of Virtual Care Across Specialties
Zachrison K, Yan Z, White B, Park L, Schwamm L. Factors Associated with the Digital Patient Experience of Virtual Care Across Specialties. Telemedicine Reports 2023, 4: 227-235. PMID: 37637376, PMCID: PMC10457601, DOI: 10.1089/tmr.2023.0032.Peer-Reviewed Original ResearchPatient experience scoresVirtual carePatient experiencePhysician levelExperience scoresHealth care systemVisit modalityAmbulatory visitsAdministrative databasesPerson careRetrospective analysisProvider characteristicsMost physiciansVisit volumePatientsPhysiciansVisit levelCare systemSufficient dataCareVisitsMedical specialtiesPerson modalityScoresModalitiesInfluence of Cortical Superficial Siderosis in Patients with Mixed Location Cerebral Microbleeds and Intracerebral Hemorrhage (S36.006)
Das A, Gokcal E, Biffi A, Regenhardt R, Fouks A, Viswanathan A, Kimberly W, Goldstein J, Schwamm L, Rosand J, Greenberg S, Gurol E. Influence of Cortical Superficial Siderosis in Patients with Mixed Location Cerebral Microbleeds and Intracerebral Hemorrhage (S36.006). Neurology 2023, 100 DOI: 10.1212/wnl.0000000000204075.Peer-Reviewed Original ResearchSMS-text messaging for collecting outcome measures after acute stroke
DiCarlo J, Erler K, Petrilli M, Emerson K, Gochyyev P, Schwamm L, Lin D. SMS-text messaging for collecting outcome measures after acute stroke. Frontiers In Digital Health 2023, 5: 1043806. PMID: 36910572, PMCID: PMC9996089, DOI: 10.3389/fdgth.2023.1043806.Peer-Reviewed Original ResearchModified Rankin ScaleAcute strokeOutcomes Measurement Information System (PROMIS) Global-10Acute stroke treatmentText messaging programsNIH Stroke ScaleOutcome data collectionHospitalization dischargeSMS text messagingHospital stayStroke ScaleMRS scoreRankin ScaleStroke treatmentFunctional outcomePROM scoresOutcome measuresWeighted Cohen's kappaPatientsSignificant associationStrokeTraditional followSMS textOutcomesParticipant satisfaction
2022
No short-term mortality from benzodiazepine use post-acute ischemic stroke after accounting for bias
Moura L, Yan Z, Donahue M, Smith L, Schwamm L, Hsu J, Newhouse J, Haneuse S, Blacker D, Hernandez-Diaz S. No short-term mortality from benzodiazepine use post-acute ischemic stroke after accounting for bias. Journal Of Clinical Epidemiology 2022, 154: 136-145. PMID: 36572369, PMCID: PMC10033385, DOI: 10.1016/j.jclinepi.2022.12.013.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeRisk differenceIschemic strokeBenzodiazepine useShort-term mortalityImmortal time biasElectronic health recordsAIS admissionsBenzodiazepine initiationStroke RegistryPoststroke mortalityTreatment initiationMortality riskPatientsFurther adjustmentMortalityBenzodiazepinesOlder adultsTime biasHealth recordsImmortal timeStrokeRiskDaysContraindicationsComparative Effectiveness and Safety of Seizure Prophylaxis Among Adults After Acute Ischemic Stroke
Moura L, Donahue M, Yan Z, Smith L, Hsu J, Newhouse J, Schwamm L, Haneuse S, Hernandez-Diaz S, Blacker D. Comparative Effectiveness and Safety of Seizure Prophylaxis Among Adults After Acute Ischemic Stroke. Stroke 2022, 54: 527-536. PMID: 36544249, PMCID: PMC9870933, DOI: 10.1161/strokeaha.122.039946.Peer-Reviewed Original ResearchConceptsSeizure prophylaxisRisk differenceAntiseizure drugsEarly seizure prophylaxisSevere AIS patientsAcute ischemic strokePrespecified subgroup analysisHealth care factorsInverse probability weightsElectronic health recordsAIS admissionsPoststroke mortalityStroke RegistryIschemic strokeAIS patientsStroke settingsCare factorsSubgroup analysisProphylaxisMortality riskHigh riskPatientsComparative effectivenessExcess deathsTrial dataThe promise of tenecteplase in acute stroke: Within reach or beyond approval?
Zachrison K, Schwamm L. The promise of tenecteplase in acute stroke: Within reach or beyond approval? Med 2022, 3: 651-655. PMID: 36202099, DOI: 10.1016/j.medj.2022.09.005.Peer-Reviewed Original ResearchSpoke‐Administered Thrombolysis Improves Large‐Vessel Occlusion Early Recanalization: The Real‐World Experience of a Large Academic Hub‐and‐Spoke Telestroke Network
Kraft A, Regenhardt R, Awad A, Rosenthal J, Dmytriw A, Vranic J, Bonkhoff A, Bretzner M, Hirsch J, Rabinov J, Stapleton C, Schwamm L, Singhal A, Rost N, Leslie‐Mazwi T, Patel A. Spoke‐Administered Thrombolysis Improves Large‐Vessel Occlusion Early Recanalization: The Real‐World Experience of a Large Academic Hub‐and‐Spoke Telestroke Network. Stroke Vascular And Interventional Neurology 2022, 3 PMID: 36816048, PMCID: PMC9936963, DOI: 10.1161/svin.122.000427.Peer-Reviewed Original ResearchIntravenous thrombolysisMechanical thrombectomyEarly recanalizationInterhospital transferLarge vessel occlusion strokeLack of efficacyReal-world analysisVessel imagingEligible patientsMedian ageOcclusion strokeRecent trialsStroke NetworkTelestroke networkInclusion criteriaPatientsIVT useReal-world experienceNIHSSThrombolysisRecanalizationHospitalLVOImagingER ratesImproving detection of cerebral small vessel disease aetiology in patients with isolated lobar intracerebral haemorrhage
Das A, Gokcal E, Regenhardt R, Horn M, Schwab K, Daoud N, Viswanathan A, Kimberly W, Goldstein J, Biffi A, Rost N, Rosand J, Schwamm L, Greenberg S, Gurol M. Improving detection of cerebral small vessel disease aetiology in patients with isolated lobar intracerebral haemorrhage. Stroke And Vascular Neurology 2022, 8: 26-33. PMID: 35981809, PMCID: PMC9985798, DOI: 10.1136/svn-2022-001653.Peer-Reviewed Original ResearchConceptsLeft ventricular hypertrophyCerebral amyloid angiopathyLobar intracerebral hemorrhageIntracerebral hemorrhageImaging markerFrequency of LVHCerebral small vessel diseaseSmall vessel diseaseAetiologic groupsLobar lacunesAmyloid angiopathyVentricular hypertrophyVessel diseasePresence/distributionPatientsDisease etiologyHemorrhageLacunesMarkersRegression modelsAngiopathyHigh frequencyHypertrophyEtiologyDiseaseTrends in characteristics of neurologists who provide stroke consultations in the USA, 2008–2021
Nakamoto C, Wilcock A, Schwamm L, Majersik J, Zachrison K, Mehrotra A. Trends in characteristics of neurologists who provide stroke consultations in the USA, 2008–2021. Stroke And Vascular Neurology 2022, 8: 86-88. PMID: 35902139, PMCID: PMC9985800, DOI: 10.1136/svn-2022-001662.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeTransient ischemic attackVascular neurologistsPatient's homeAIS/transient ischemic attackHigh-volume providersNeurologist consultationTIA episodesIschemic attackIschemic strokeStroke consultationsNeurologistsService MedicarePhysician practicesStudy periodConsultsPatientsEpisodesConsultationHomeHospitalStrokeProportionIschemic Stroke Systems of Care in California: Evolution in the Organization During the Mechanical Thrombectomy Era
Zachrison K, Hsia R, Li S, Reeves M, Camargo C, Yan Z, Onnela J, Schwamm L. Ischemic Stroke Systems of Care in California: Evolution in the Organization During the Mechanical Thrombectomy Era. Stroke Vascular And Interventional Neurology 2022, 2 DOI: 10.1161/svin.121.000206.Peer-Reviewed Original ResearchEndovascular thrombectomyStroke systemsHospital-level factorsOdds of transferLogistic regression modelsAlteplase useEVT proceduresStroke NetworkObservational studyTimely careRural hospitalsTrial dataHospitalPatientsHospital postsHospital pairsCarePatient transfer networksRegression modelsNumber of encountersLinear regressionThrombectomyAlteplaseRegressionGreater POSTDifferences in Performance on Quality Measures for Thrombectomy‐Capable Stroke Centers Compared With Comprehensive Stroke Centers in 2019 to 2020
Baker D, Schmaltz S, Kolbusz K, Messé S, Jauch E, Schwamm L. Differences in Performance on Quality Measures for Thrombectomy‐Capable Stroke Centers Compared With Comprehensive Stroke Centers in 2019 to 2020. Stroke Vascular And Interventional Neurology 2022, 2 DOI: 10.1161/svin.121.000302.Peer-Reviewed Original ResearchComprehensive stroke centerLarge vessel occlusionMechanical thrombectomyStroke centersSkin punctureCerebral infarctionMedian timeStroke center certificationSymptomatic hemorrhagic complicationsSymptomatic hemorrhagic transformationPercentage of patientsProportion of patientsSuccessful mechanical thrombectomyThrombectomy-capable stroke centersProlonged transport timesWilcoxon rank sum testRank sum testHemorrhagic transformationHemorrhagic complicationsStroke careCenter certificationSigned-rank testCurrent recommendationsPatientsMedian proportionEvaluation of Evidence-Based Dual Antiplatelet Therapy for Secondary Prevention in US Patients With Acute Ischemic Stroke
Xian Y, Xu H, Smith E, Fonarow G, Bhatt D, Schwamm L, Peterson E. Evaluation of Evidence-Based Dual Antiplatelet Therapy for Secondary Prevention in US Patients With Acute Ischemic Stroke. JAMA Internal Medicine 2022, 182: 559-564. PMID: 35344009, PMCID: PMC8961397, DOI: 10.1001/jamainternmed.2022.0323.Peer-Reviewed Original ResearchRationale and design of a stepped wedge cluster randomised trial to improve acute reperfusion treatment quality for stroke: IMPROVE stroke care in China
Li Z, Wang C, Zhang X, Zong L, Zhou H, Gu H, Jiang Y, Pan Y, Meng X, Zhou Q, Zhao H, Yang X, Wang M, Xiong Y, Zhao X, Wang Y, Liu L, Ma X, Morgan L, Xian Y, Schwamm L, Wang Y. Rationale and design of a stepped wedge cluster randomised trial to improve acute reperfusion treatment quality for stroke: IMPROVE stroke care in China. Stroke And Vascular Neurology 2022, 7: 451-456. PMID: 35354662, PMCID: PMC9614172, DOI: 10.1136/svn-2021-001461.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeIntravenous thrombolysisReperfusion therapyEndovascular thrombectomyEligible patientsPrimary outcomeWedge clusterQuality improvement interventionsMixed-effects logistic regressionTreatment qualityIntraclass correlation coefficientReperfusion treatmentHospital delayIschemic strokeStroke centersTreat principleStroke careEfficacy analysisChina trialEffective treatmentNumber of casesImprovement interventionsPatientsComprehensive interventionLogistic regressionIn a hub-and-spoke network, spoke-administered thrombolysis reduces mechanical thrombectomy procedure time and number of passes
Kraft A, Awad A, Rosenthal J, Dmytriw A, Vranic J, Bonkhoff A, Bretzner M, Hirsch J, Rabinov J, Stapleton C, Schwamm L, Rost N, Leslie-Mazwi T, Patel A, Regenhardt R. In a hub-and-spoke network, spoke-administered thrombolysis reduces mechanical thrombectomy procedure time and number of passes. Interventional Neuroradiology 2022, 29: 315-320. PMID: 35317663, PMCID: PMC10369105, DOI: 10.1177/15910199221087498.Peer-Reviewed Original ResearchConceptsLarge vessel occlusion strokeIntravenous thrombolysisIVT-treated patientsMechanical thrombectomyProcedure timePuncture timeImproved reperfusionBaseline characteristicsTICI 2bIVT patientsOcclusion strokeOperative reportsProcedural characteristicsTelestroke networkPatientsReperfusionIncreased proportionThrombolysisTechnical difficultiesNIHSSThrombectomyHospitalStrokeMin