2023
Distinguishing Distinct Neural Systems for Proximal vs Distal Upper Extremity Motor Control After Acute Stroke
Lin D, Hardstone R, DiCarlo J, Mckiernan S, Snider S, Jacobs H, Erler K, Rishe K, Boyne P, Goldsmith J, Ranford J, Finklestein S, Schwamm L, Hochberg L, Cramer S. Distinguishing Distinct Neural Systems for Proximal vs Distal Upper Extremity Motor Control After Acute Stroke. Neurology 2023, 101: e347-e357. PMID: 37268437, PMCID: PMC10435065, DOI: 10.1212/wnl.0000000000207417.Peer-Reviewed Original ResearchMeSH KeywordsFemaleHumansMaleMotor CortexRecovery of FunctionStrokeStroke RehabilitationUpper ExtremityConceptsDistal motor controlUpper extremity motor deficitsAcute strokeBarthel IndexMotor deficitsMotor controlAcute stroke patientsUpper extremity hemiparesisUpper extremity motor controlRegion of injuryLesion-symptom mappingMotor systemHealthy CNSDays poststrokeDistal injuriesRankin ScaleStroke onsetConsecutive patientsStroke patientsMotor scoresClinical syndromeFunctional outcomeIntact CNSPosterior aspectPrecentral gyrus
2022
Association of Modified Rankin Scale With Recovery Phenotypes in Patients With Upper Extremity Weakness After Stroke
Erler K, Wu R, DiCarlo J, Petrilli M, Gochyyev P, Hochberg L, Kautz S, Schwamm L, Cramer S, Finklestein S, Lin D. Association of Modified Rankin Scale With Recovery Phenotypes in Patients With Upper Extremity Weakness After Stroke. Neurology 2022, 98: e1877-e1885. PMID: 35277444, PMCID: PMC9109148, DOI: 10.1212/wnl.0000000000200154.Peer-Reviewed Original ResearchMeSH KeywordsActivities of Daily LivingHumansPhenotypeRecovery of FunctionStrokeStroke RehabilitationUpper ExtremityConceptsModified Rankin ScaleUpper extremity weaknessMRS scoreStroke trialsFunctional outcomeOutcome measuresMRS levelsExtremity weaknessRankin ScaleMRS outcomesMotor impairmentFuture stroke trialsDaily living statusUpper extremity impairmentMeaningful changeGlobal outcome measuresMeaningful clinical changeIschemic strokeFugl-MeyerGrip strengthMotor phenotypeClinical changesClinical careDaily livingPatients
2019
Comparison of Clinical Care and In-Hospital Outcomes of Asian American and White Patients With Acute Ischemic Stroke
Song S, Liang L, Fonarow G, Smith E, Bhatt D, Matsouaka R, Xian Y, Schwamm L, Saver J. Comparison of Clinical Care and In-Hospital Outcomes of Asian American and White Patients With Acute Ischemic Stroke. JAMA Neurology 2019, 76: 430-439. PMID: 30667466, PMCID: PMC6459126, DOI: 10.1001/jamaneurol.2018.4410.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAsianBrain IschemiaFemaleFibrinolytic AgentsHealthcare DisparitiesHospital MortalityHumansHydroxymethylglutaryl-CoA Reductase InhibitorsIntracranial HemorrhagesLogistic ModelsMaleMiddle AgedMultivariate AnalysisPatient DischargeQuality of Health CareRetrospective StudiesSeverity of Illness IndexStrokeStroke RehabilitationThrombolytic TherapyTime-to-TreatmentTissue Plasminogen ActivatorTreatment OutcomeUnited StatesWhite PeopleConceptsAcute ischemic strokeAsian American patientsIschemic strokeWhite patientsAmerican patientsClinical outcomesHospital mortalityStroke severityAmerican Heart Association/American Stroke AssociationIntravenous tissue plasminogen activator administrationTissue plasminogen activator administrationMultivariable logistic regression modelGreater stroke severityGuidelines-Stroke programGWTG-Stroke hospitalsIntensive statin therapyOverall stroke incidenceIn-Hospital OutcomesSevere ischemic strokeWorse functional outcomeAmerican Stroke AssociationQuality improvement registryLogistic regression modelsRace/ethnicityStatin therapy
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 practiceFactors 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 Institute
2017
Unexplained Variation for Hospitals’ Use of Inpatient Rehabilitation and Skilled Nursing Facilities After an Acute Ischemic Stroke
Xian Y, Thomas L, Liang L, Federspiel J, Webb L, Bushnell C, Duncan P, Schwamm L, Stein J, Fonarow G, Hoenig H, Montalvo C, George M, Lutz B, Peterson E, Bettger J. Unexplained Variation for Hospitals’ Use of Inpatient Rehabilitation and Skilled Nursing Facilities After an Acute Ischemic Stroke. Stroke 2017, 48: 2836-2842. PMID: 28830975, DOI: 10.1161/strokeaha.117.016904.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBrain IschemiaFemaleHospitalizationHumansMaleRegistriesSkilled Nursing FacilitiesStrokeStroke RehabilitationConceptsInpatient rehabilitation facilitySkilled nursing facilitiesAcute ischemic strokeHospital-level variationIschemic strokeNursing facilitiesGuidelines-Stroke hospitalsMultilevel logistic regression modelsMedian odds ratioGeographic availabilityLogistic regression modelsIRF patientsHospital complicationsSNF patientsClinical characteristicsComorbid conditionsInpatient rehabilitationHospital characteristicsClinical registryOdds ratioRehabilitation facilityHospital useMedicare beneficiariesPatientsHospitalImproving transitions in acute stroke patients discharged to home: the Michigan stroke transitions trial (MISTT) protocol
Reeves M, Hughes A, Woodward A, Freddolino P, Coursaris C, Swierenga S, Schwamm L, Fritz M. Improving transitions in acute stroke patients discharged to home: the Michigan stroke transitions trial (MISTT) protocol. BMC Neurology 2017, 17: 115. PMID: 28623892, PMCID: PMC5474297, DOI: 10.1186/s12883-017-0895-1.Peer-Reviewed Original ResearchMeSH KeywordsAdultCaregiversHumansMichiganPatient DischargeQuality of LifeStrokeStroke RehabilitationSurvivorsConceptsAcute stroke patientsCase management programPatient Activation MeasureStroke patientsCaregiver outcomesTransition trialsRehabilitation facilityAdult acute stroke patientsBakas Caregiving Outcomes ScalePrimary caregiversOutcome 3 monthsPrimary patient outcomePatient's primary caregiverEvidence-based standardsHealth-related challengesUsual careHospital dischargeSuperiority trialEligible participantsOutcome ScaleTrial protocolPatient outcomesStudy interventionMichigan hospitalsOutcome data
2016
Impact of Insurance Status on Outcomes and Use of Rehabilitation Services in Acute Ischemic Stroke: Findings From Get With The Guidelines‐Stroke
Medford‐Davis L, Fonarow G, Bhatt D, Xu H, Smith E, Suter R, Peterson E, Xian Y, Matsouaka R, Schwamm L. Impact of Insurance Status on Outcomes and Use of Rehabilitation Services in Acute Ischemic Stroke: Findings From Get With The Guidelines‐Stroke. Journal Of The American Heart Association 2016, 5: e004282. PMID: 27930356, PMCID: PMC5210352, DOI: 10.1161/jaha.116.004282.Peer-Reviewed Original ResearchMeSH KeywordsAgedAmbulancesAnticholesteremic AgentsAntihypertensive AgentsBrain IschemiaDiabetes MellitusFemaleGuideline AdherenceHospital MortalityHumansHypercholesterolemiaHypertensionHypoglycemic AgentsInsurance CoverageInsurance, HealthLogistic ModelsMaleMedicaidMedically UninsuredMedicareMiddle AgedMultivariate AnalysisOdds RatioPractice Guidelines as TopicSkilled Nursing FacilitiesStrokeStroke RehabilitationTime FactorsUnited StatesConceptsAcute ischemic strokeIschemic strokeInsurance statusHospital mortalityGuidelines-Stroke programIschemic stroke patientsMultivariable logistic regressionPatient insurance statusGovernment-sponsored insuranceSkilled nursing facilitiesGuidelines-StrokeInpatient rehabPostdischarge destinationHospital outcomesPatient demographicsSymptom onsetAcute treatmentControl medicationDiabetes mellitusStroke patientsHospital characteristicsUninsured patientsHigh cholesterolNursing facilitiesPreventative care
2015
Contemporary Trends and Predictors of Postacute Service Use and Routine Discharge Home After Stroke
Bettger J, McCoy L, Smith E, Fonarow G, Schwamm L, Peterson E. Contemporary Trends and Predictors of Postacute Service Use and Routine Discharge Home After Stroke. Journal Of The American Heart Association 2015, 4: e001038. PMID: 25713291, PMCID: PMC4345857, DOI: 10.1161/jaha.114.001038.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overBrain IschemiaFemaleHome Health NursingHospitalizationHumansIntracranial HemorrhagesLength of StayMaleMiddle AgedMultivariate AnalysisPatient DischargeRecovery of FunctionRehabilitation CentersRisk FactorsSelf CareSkilled Nursing FacilitiesStrokeStroke RehabilitationTreatment OutcomeWalkingConceptsInpatient rehabilitation facilityPAC useSkilled nursing facilitiesHome healthStroke patientsService useHealth insurance typeHospital discharge dispositionStrongest clinical predictorsYears of agePostacute care servicesGuidelines-StrokeDischarge homeHospital stayDischarge dispositionClinical predictorsHemorrhagic strokeOral intakeDysphagia screenMultivariable analysisAcute careStroke hospitalizationsInsurance typeSNF useNursing facilities
2014
Clinical Commentary on “Certain Uncertainty
O'Brien E, Xian Y, Fonarow G, Olson D, Schwamm L, Hernandez A. Clinical Commentary on “Certain Uncertainty. Circulation Cardiovascular Quality And Outcomes 2014, 7: 970. PMID: 25387781, DOI: 10.1161/circoutcomes.114.001484.Peer-Reviewed Original ResearchDeterminants of Early Outcomes in Patients with Acute Ischemic Stroke and Proximal Artery Occlusion
LaBuzetta J, Yoo A, Ali S, Fitzpatrick K, Leslie-Mazwi T, Hirsch J, Schwamm L, Rost N. Determinants of Early Outcomes in Patients with Acute Ischemic Stroke and Proximal Artery Occlusion. Journal Of Stroke And Cerebrovascular Diseases 2014, 23: 2527-2532. PMID: 25238927, PMCID: PMC4256100, DOI: 10.1016/j.jstrokecerebrovasdis.2014.03.020.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, IntravenousAgedAged, 80 and overArterial Occlusive DiseasesBrain IschemiaCombined Modality TherapyEndovascular ProceduresFemaleFibrinolytic AgentsHumansInjections, Intra-ArterialLogistic ModelsMaleMiddle AgedPatient DischargeProspective StudiesRegional Blood FlowStrokeStroke RehabilitationTime FactorsTissue Plasminogen ActivatorTreatment OutcomeConceptsIntra-arterial therapyProximal artery occlusionArtery occlusionIndependent predictorsAIS patientsPoststroke outcomesFavorable outcomeAcute ischemic stroke patientsIntravenous tissue plasminogen activatorInstitutional stroke databaseAcute ischemic strokeIschemic stroke patientsOnly independent predictorTissue plasminogen activatorEligible patientsHospital mortalityTPA administrationIschemic strokeStroke databaseAtrial fibrillationEarly outcomesPrespecified protocolStroke patientsPatient subgroupsUnfavorable outcomeAdherence to Third European Cooperative Acute Stroke Study 3- to 4.5-Hour Exclusions and Association With Outcome
Cronin CA, Sheth KN, Zhao X, Messé SR, Olson DM, Hernandez AF, Bhatt DL, Schwamm LH, Smith EE. Adherence to Third European Cooperative Acute Stroke Study 3- to 4.5-Hour Exclusions and Association With Outcome. Stroke 2014, 45: 2745-2749. PMID: 25104846, DOI: 10.1161/strokeaha.114.005443.Peer-Reviewed Original ResearchConceptsAdditional exclusion criteriaExclusion criteriaDiabetes mellitusAmerican Heart Association/American Stroke Association guidelinesEuropean Cooperative Acute Stroke StudyAmerican Stroke Association guidelinesSymptomatic intracranial hemorrhageWorse hospital outcomesHealth Stroke ScalePercent of patientsHistory of strokeOral anticoagulant treatmentCertain patient groupsAcute Stroke StudyTreatment time windowHour windowECASS IIIGuidelines-StrokePrior strokeAnticoagulant treatmentHospital outcomesStroke ScaleIschemic strokeSymptom onsetIncreased riskUse of a Standardized Assessment to Predict Rehabilitation Care After Acute Stroke
Stein J, Bettger J, Sicklick A, Hedeman R, Magdon-Ismail Z, Schwamm L. Use of a Standardized Assessment to Predict Rehabilitation Care After Acute Stroke. Archives Of Physical Medicine And Rehabilitation 2014, 96: 210-217. PMID: 25102387, DOI: 10.1016/j.apmr.2014.07.403.Peer-Reviewed Original ResearchConceptsInpatient rehabilitation facilitySkilled nursing facilitiesInstitution-based rehabilitationPredictors of referralDischarge homeBarthel IndexBI scoreRehabilitation needsSociodemographic characteristicsShort Portable Mental Status QuestionnaireDischarge disposition locationGuidelines-Stroke registryHealth Stroke ScalePatients' sociodemographic characteristicsDaily living impairmentStandardized assessmentHigher BI scoreMental Status QuestionnaireProspective pilot projectPrestroke disabilityStroke ScaleAcute strokeClinical characteristicsOlder patientsRankin Scale
2013
Review of Stroke Center Effectiveness and Other Get with the Guidelines Data
Silva G, Schwamm L. Review of Stroke Center Effectiveness and Other Get with the Guidelines Data. Current Atherosclerosis Reports 2013, 15: 350. PMID: 23892766, DOI: 10.1007/s11883-013-0350-8.Peer-Reviewed Original ResearchMeSH KeywordsEmergency Medical ServicesEvidence-Based PracticeHospitals, SpecialHumansLong-Term CarePractice Guidelines as TopicStrokeStroke RehabilitationUnited StatesConceptsStroke systemsAcute careAcute stroke-ready hospitalGuidelines-Stroke programSpectrum of strokeStroke-ready hospitalsComprehensive stroke centerBest evidence-based careEvidence-based careAmerican Heart AssociationEmergency medical servicesSecondary preventionStroke centersStroke carePrimary preventionHeart AssociationCoordinated careCare processesPatient accessCareCare comprisesStrokeMedical servicesPreventionGuideline data
2012
Assessing Stroke Patients for Rehabilitation During the Acute Hospitalization: Findings From the Get With The Guidelines–Stroke Program
Bettger J, Kaltenbach L, Reeves M, Smith E, Fonarow G, Schwamm L, Peterson E. Assessing Stroke Patients for Rehabilitation During the Acute Hospitalization: Findings From the Get With The Guidelines–Stroke Program. Archives Of Physical Medicine And Rehabilitation 2012, 94: 38-45. PMID: 22858797, DOI: 10.1016/j.apmr.2012.06.029.Peer-Reviewed Original ResearchConceptsGuidelines-Stroke programStroke patientsAcute hospitalizationAcute strokeAcute hospitalsGWTG-Stroke programAcute stroke patientsProspective cohortStroke unitMultivariable analysisNonwhite raceRehabilitation careAcute assessmentMAIN OUTCOMEStroke diagnosisPatientsRehabilitation servicesHospitalizationRehabilitationHospitalStrokeUnited StatesAssessmentAdmissionCohort
2010
Stroke: working toward a prioritized world agenda
Hachinski V, Donnan G, Gorelick P, Hacke W, Cramer S, Kaste M, Fisher M, Brainin M, Buchan A, Lo E, Skolnick B, Furie K, Hankey G, Kivipelto M, Morris J, Rothwell P, Sacco R, Smith S, Wang Y, Bryer A, Ford G, Iadecola C, Martins S, Saver J, Skvortsova V, Bayley M, Bednar M, Duncan P, Enney L, Finklestein S, Jones T, Kalra L, Kleim J, Nitkin R, Teasell R, Weiller C, Desai B, Goldberg M, Heiss W, Saarelma O, Schwamm L, Shinohara Y, Trivedi B, Wahlgren N, Wong L, Hakim A, Norrving B, Prudhomme S, Bornstein N, Davis S, Goldstein L, Leys D, Tuomilehto J. Stroke: working toward a prioritized world agenda. International Journal Of Stroke 2010, 5: 238-256. PMID: 20636706, PMCID: PMC3712839, DOI: 10.1111/j.1747-4949.2010.00442.x.Peer-Reviewed Original ResearchConceptsStroke careChronic disease prevention initiativeStroke-related informationEmergency stroke careDisease prevention initiativesPublic health communication strategiesConsequences of strokeRigorous clinical researchHealth communication strategiesStroke preventionStroke centersStroke unitClinical strokeSubclinical strokeBrain recoveryCerebrovascular diseaseStroke recoveryBrain healthPoststroke rehabilitationTelestroke networkClinical careHuman studiesEpidemiological disciplinesSurrogate assessmentStrokeStroke: Working Toward a Prioritized World Agenda
Hachinski V, Donnan G, Gorelick P, Hacke W, Cramer S, Kaste M, Fisher M, Brainin M, Buchan A, Lo E, Skolnick B, Furie K, Hankey G, Kivipelto M, Morris J, Rothwell P, Sacco R, Smith S, Wang Y, Bryer A, Ford G, Iadecola C, Martins S, Saver J, Skvortsova V, Bayley M, Bednar M, Duncan P, Enney L, Finklestein S, Jones T, Kalra L, Kleim J, Nitkin R, Teasell R, Weiller C, Desai B, Goldberg M, Heiss W, Saarelma O, Schwamm L, Shinohara Y, Trivedi B, Wahlgren N, Wong L, Hakim A, Norrving B, Prudhomme S, Bornstein N, Davis S, Goldstein L, Leys D, Tuomilehto J. Stroke: Working Toward a Prioritized World Agenda. Stroke 2010, 41: 1084-1099. PMID: 20498453, PMCID: PMC3712843, DOI: 10.1161/strokeaha.110.586156.Peer-Reviewed Original ResearchMeSH KeywordsAnimalsBiomedical ResearchDatabases, FactualEducation, Medical, ContinuingHumansPatient Education as TopicRegistriesStrokeStroke RehabilitationConceptsStroke careChronic disease prevention initiativeStroke-related informationEmergency stroke careDisease prevention initiativesPublic health communication strategiesConsequences of strokeRigorous clinical researchHealth communication strategiesStroke preventionStroke centersStroke unitClinical strokeSubclinical strokeBrain recoveryCerebrovascular diseaseStroke recoveryBrain healthPoststroke rehabilitationTelestroke networkClinical careHuman studiesEpidemiological disciplinesSurrogate assessmentStroke
2009
Telestroke: Scientific Results
Audebert H, Schwamm L. Telestroke: Scientific Results. Cerebrovascular Diseases 2009, 27: 15-20. PMID: 19546537, DOI: 10.1159/000213054.Peer-Reviewed Original ResearchMeSH KeywordsEmergency Medical ServicesHumansLong-Term CareNeurologyStrokeStroke RehabilitationTelemedicineThrombolytic TherapyConceptsStroke careStroke patientsAcute stroke treatment decisionsPost-stroke careTriage of patientsTelephone-based consultationsUse of telemedicineVideo examinationIntravenous thrombolysisStroke preventionStroke wardAcute strokeClinical outcomesNeurological assessmentInterventional treatmentTreatment decisionsApplication of telemedicineTelemedicine consultationsBrain scansPatientsUnderserved areasHigh-quality videoconferencingThrombolysisCareHospitalRecommendations for the Implementation of Telemedicine Within Stroke Systems of Care
Schwamm L, Audebert H, Amarenco P, Chumbler N, Frankel M, George M, Gorelick P, Horton K, Kaste M, Lackland D, Levine S, Meyer B, Meyers P, Patterson V, Stranne S, White C. Recommendations for the Implementation of Telemedicine Within Stroke Systems of Care. Stroke 2009, 40: 2635-2660. PMID: 19423851, DOI: 10.1161/strokeaha.109.192361.Peer-Reviewed Original ResearchA Review of the Evidence for the Use of Telemedicine Within Stroke Systems of Care
Schwamm L, Holloway R, Amarenco P, Audebert H, Bakas T, Chumbler N, Handschu R, Jauch E, Knight W, Levine S, Mayberg M, Meyer B, Meyers P, Skalabrin E, Wechsler L. A Review of the Evidence for the Use of Telemedicine Within Stroke Systems of Care. Stroke 2009, 40: 2616-2634. PMID: 19423852, DOI: 10.1161/strokeaha.109.192360.Peer-Reviewed Original ResearchConceptsUse of telemedicineStroke systemsStroke treatmentAmerican Heart Association/American CollegeStroke care deliveryAcute stroke treatmentEvidence-based reviewEvidence-based recommendationsEmergency medical servicesSecondary preventionNeurological assessmentPrimary preventionEmergency departmentCardiology FoundationConsensus recommendationsAmerican CollegeClass of evidenceCare deliveryAvailable evidenceCare frameworkMedical servicesPreventionTelemedicineTreatmentLevel of certainty