2023
Performance of Thrombectomy-Capable, Comprehensive, and Primary Stroke Centers in Reperfusion Therapies for Acute Ischemic Stroke: Report From the Get With The Guidelines–Stroke Registry
Raychev R, Sun J, Schwamm L, Smith E, Fonarow G, Messé S, Xian Y, Chiswell K, Blanco R, Mac Grory B, Saver J. Performance of Thrombectomy-Capable, Comprehensive, and Primary Stroke Centers in Reperfusion Therapies for Acute Ischemic Stroke: Report From the Get With The Guidelines–Stroke Registry. Circulation 2023, 148: 2019-2028. PMID: 37855118, DOI: 10.1161/circulationaha.123.066114.Peer-Reviewed Original ResearchConceptsComprehensive stroke centerPrimary stroke centerThrombectomy-capable stroke centersAcute ischemic strokeGuidelines-Stroke registryEndovascular thrombectomyStroke centersReperfusion therapyIschemic strokeClinical outcomesHealth Stroke Scale scoreClinical efficacy outcomesStroke Scale scoreHigher National InstitutesOdds of dischargeGoal doorEVT proceduresHospital mortalityIntravenous thrombolysisEfficacy outcomesSuccessful reperfusionCohort studyDischarge destinationNeedle timePuncture time
2022
Race-Ethnic Disparities in Rates of Declination of Thrombolysis for Stroke
Mendelson S, Zhang S, Matsouaka R, Xian Y, Shah S, Lytle B, Solomon N, Schwamm L, Smith E, Saver J, Fonarow G, Holl J, Prabhakaran S. Race-Ethnic Disparities in Rates of Declination of Thrombolysis for Stroke. Neurology 2022, 98: e1596-e1604. PMID: 35228335, PMCID: PMC9052571, DOI: 10.1212/wnl.0000000000200138.Peer-Reviewed Original ResearchConceptsTissue plasminogen activatorNon-Hispanic black patientsTPA-eligible patientsRace/ethnicityBlack patientsNon-Hispanic black race/ethnicityNon-Hispanic white patientsBlack race/ethnicityAsian race/ethnicityGuidelines-Stroke registryPrimary stroke centerSingle-center studyMultivariable logistic regressionRace-ethnic disparitiesNon-Hispanic whitesEligible patientsHospital factorsNationwide registryPatient demographicsStroke centersSymptom onsetWhite patientsMultivariable analysisStroke careAsian patients
2021
Association of Hospital Telestroke Adoption With Changes in Initial Hospital Presentation and Transfers Among Patients With Stroke and Transient Ischemic Attacks
Zachrison K, Richard J, Wilcock A, Zubizaretta J, Schwamm L, Uscher-Pines L, Mehrotra A. Association of Hospital Telestroke Adoption With Changes in Initial Hospital Presentation and Transfers Among Patients With Stroke and Transient Ischemic Attacks. JAMA Network Open 2021, 4: e2126612. PMID: 34554236, PMCID: PMC8461501, DOI: 10.1001/jamanetworkopen.2021.26612.Peer-Reviewed Original ResearchConceptsHospital stroke volumeControl hospitalsStroke volumeStroke centersStroke symptomsStroke systemsCase mixTransient ischemic attack admissionsHospital pairsInitial hospital presentationThrombectomy-capable hospitalsComprehensive stroke centerTransient ischemic attackPrimary stroke centerCross-sectional studyMajor teaching hospitalObserved patient characteristicsBed sizeHospital presentationIschemic attackInitial hospitalCritical access hospitalsPatient characteristicsInterhospital transferPostimplementation period
2018
Comparison of Acute Ischemic Stroke Care and Outcomes Between Comprehensive Stroke Centers and Primary Stroke Centers in the United States
Man S, Zhao X, Uchino K, Hussain M, Smith E, Bhatt D, Xian Y, Schwamm L, Shah S, Khan Y, Fonarow G. Comparison of Acute Ischemic Stroke Care and Outcomes Between Comprehensive Stroke Centers and Primary Stroke Centers in the United States. Circulation Cardiovascular Quality And Outcomes 2018, 11: e004512. PMID: 29794035, PMCID: PMC5978771, DOI: 10.1161/circoutcomes.117.004512.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBrain IschemiaCertificationComprehensive Health CareDelivery of Health Care, IntegratedEmergency Service, HospitalEndovascular ProceduresFemaleHospital MortalityHospitalsHumansMaleMiddle AgedOutcome and Process Assessment, Health CarePatient AdmissionPatient TransferQuality ImprovementQuality Indicators, Health CareRecovery of FunctionRegistriesRisk AssessmentRisk FactorsStrokeThrombolytic TherapyTime FactorsTime-to-TreatmentTreatment OutcomeUnited StatesConceptsPrimary stroke centerEmergency department admissionsStroke center certificationAcute ischemic strokeIschemic stroke careStroke centersStroke careDepartment admissionsHospital mortalityHospital outcomesIntravenous tPAIschemic strokeCenter certificationTPA timeComprehensive Stroke Center (CSC) certificationAcute ischemic stroke careMultivariable logistic regression modelAcute reperfusion therapyAcute stroke triageBrain Attack CoalitionDefect-free careComprehensive stroke centerOverall care qualityLogistic regression modelsGuidelines-Stroke
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 documentationTelestroke
Rubin M, Demaerschalk B, Schwamm L, Wechsler L. Telestroke. 2015, 47-57. DOI: 10.1007/978-1-4939-2349-6_5.Peer-Reviewed Original ResearchSecondary preventionStroke careHealth Stroke Scale scoreMajor public health problemStroke Scale scoreAcute ischemic strokeAcute stroke carePrimary stroke centerAcute stroke evaluationPrevention of complicationsEducation of patientsPublic health problemPrehospital emergency medical systemEmergency medical systemExcellent interrater agreementStroke practiceStroke providersTelestroke modelIschemic strokeStroke centersStroke evaluationCerebrovascular diseaseEvidence-based practicePoststroke outcomesBedside assessment
2011
Improvement in use of anticoagulation therapy in patients with ischemic stroke: Results from Get With The Guidelines–Stroke
Lewis W, Fonarow G, Grau-Sepulveda M, Smith E, Bhatt D, Hernandez A, Olson D, Peterson E, Schwamm L. Improvement in use of anticoagulation therapy in patients with ischemic stroke: Results from Get With The Guidelines–Stroke. American Heart Journal 2011, 162: 692-699.e2. PMID: 21982662, DOI: 10.1016/j.ahj.2011.07.019.Peer-Reviewed Original ResearchConceptsTransient ischemic attackUse of anticoagulationAtrial fibrillationAnticoagulation therapyGWTG-StrokeEligible patientsStroke patientsIschemic stroke/transient ischemic attackJoint Commission Primary Stroke CentersStroke/transient ischemic attackEligible AF patientsGuidelines-Stroke programIschemic stroke patientsPrimary stroke centerHospital-level characteristicsAnticoagulation useGuidelines-StrokeIschemic attackThromboembolic eventsHospital dischargeIschemic strokeOlder patientsStroke centersAF patientsHispanic patients
2008
Stroke Center Designation Can be Achieved by Small Hospitals
Smith E, Dreyer P, Prvu-Bettger J, Abdullah A, Palmeri G, Goyette L, McElligott C, Schwamm L. Stroke Center Designation Can be Achieved by Small Hospitals. Critical Pathways In Cardiology A Journal Of Evidence-Based Medicine 2008, 7: 173-177. PMID: 18791405, DOI: 10.1097/hpc.0b013e318184e2bc.Peer-Reviewed Original ResearchConceptsAcute stroke teamSmall hospitalsStroke teamMassachusetts hospitalsStroke center designationTeaching hospital statusAcute ischemic strokeAcute stroke carePrimary stroke centerMassachusetts DepartmentPublic healthStroke RegistryIschemic strokeStroke centersStroke careStroke servicesCenter designationCare pathwayHospital characteristicsHospital statusTelemedicine consultationsHospitalTomography scanningLarge hospitalsBed size