2022
The relationship between stroke system organization and disparities in access to stroke center care in California
Zachrison K, Samuels‐Kalow M, Li S, Yan Z, Reeves M, Hsia R, Schwamm L, Camargo C. The relationship between stroke system organization and disparities in access to stroke center care in California. Journal Of The American College Of Emergency Physicians Open 2022, 3: e12706. PMID: 35316966, PMCID: PMC8921441, DOI: 10.1002/emp2.12706.Peer-Reviewed Original ResearchIschemic stroke patientsInterhospital transferStroke patientsReperfusion interventionsCenter careEthnic disparitiesAcute ischemic stroke patientsNon-Hispanic black patientsAsian/Pacific Islander patientsAcute ischemic strokeComprehensive stroke centerOdds of dischargeHospital-level characteristicsPacific Islander patientsNon-Hispanic Asian/Pacific IslandersNon-Hispanic blacksAsian/Pacific IslandersInterhospital patient transfersOutcomes of interestNon-Hispanic whitesHierarchical logistic regressionReperfusion therapyHospital dischargeIschemic strokeStroke centers
2021
'Drip-and-ship' intravenous thrombolysis and outcomes for large vessel occlusion thrombectomy candidates in a hub-and-spoke telestroke model
Regenhardt R, Rosenthal J, Awad A, Martinez-Gutierrez J, Nolan N, McIntyre J, Whitney C, Alotaibi N, Dmytriw A, Vranic J, Stapleton C, Patel A, Rost N, Schwamm L, Leslie-Mazwi T. 'Drip-and-ship' intravenous thrombolysis and outcomes for large vessel occlusion thrombectomy candidates in a hub-and-spoke telestroke model. Journal Of NeuroInterventional Surgery 2021, 14: 650-653. PMID: 34326197, PMCID: PMC8799754, DOI: 10.1136/neurintsurg-2021-017819.Peer-Reviewed Original ResearchConceptsEndovascular thrombectomyIntravenous thrombolysisIntracerebral hemorrhageDay mRSEVT candidatesFunctional independenceHealth Stroke Scale scoreEmergent large vessel occlusionRisk of ICHMedian National InstitutesStroke Scale scoreLarge vessel occlusionOutcomes of interestAlteplase useDischarge mRSTelestroke modelThrombectomy candidatesEligible patientsIntravenous alteplaseTICI 2bAdequate reperfusionMedian ageSpoke hospitalsCT scoreVessel occlusionPatient characteristics associated with the successful transition to virtual care: Lessons learned from the first million patients
Zachrison K, Yan Z, Sequist T, Licurse A, Tan-McGrory A, Erskine A, Schwamm L. Patient characteristics associated with the successful transition to virtual care: Lessons learned from the first million patients. Journal Of Telemedicine And Telecare 2021, 29: 621-631. PMID: 34120506, DOI: 10.1177/1357633x211015547.Peer-Reviewed Original ResearchConceptsVirtual participantsVirtual participationBehavioral health visitsVirtual carePatient characteristicsHealth visitsInternet accessElectronic health record dataVideoNon-Hispanic black raceLarge integrated health systemHealth record dataAmbulatory care patientsIntegrated health systemVisit frequencyUse of telehealthOutcomes of interestPatient portalsAmbulatory visitsCare patientsBlack raceVisit typeVulnerable patientsCOVID patientsLimited English proficiency
2020
Impact of Emergency Department Crowding on Delays in Acute Stroke Care
Jaffe T, Goldstein J, Yun B, Etherton M, Leslie-Mazwi T, Schwamm L, Zachrison K. Impact of Emergency Department Crowding on Delays in Acute Stroke Care. Western Journal Of Emergency Medicine 2020, 21: 892-899. PMID: 32726261, PMCID: PMC7390586, DOI: 10.5811/westjem.2020.5.45873.Peer-Reviewed Original ResearchConceptsAcute stroke careStroke careED crowdingEndovascular therapyConsecutive acute ischemic stroke patientsCare deliveryAcute ischemic stroke patientsGroin puncture timeGuidelines-Stroke registryStroke care deliveryHealth Stroke ScaleIschemic stroke patientsMultiple clinical factorsUrban academic EDInitial stroke severityHigh ED utilizationSingle-institution analysisAcute care deliveryEmergency stroke careOutcomes of interestWilcoxon rank sum testEmergency department (ED) crowdingRank sum testAlteplase deliveryDTN time
2019
Thrombolytic therapy in older acute ischemic stroke patients with gastrointestinal malignancy or recent bleeding
Inohara T, Liang L, Kosinski A, Smith E, Schwamm L, Hernandez A, Bhatt D, Fonarow G, Peterson E, Xian Y. Thrombolytic therapy in older acute ischemic stroke patients with gastrointestinal malignancy or recent bleeding. European Stroke Journal 2019, 5: 47-55. PMID: 32232169, PMCID: PMC7092738, DOI: 10.1177/2396987319871784.Peer-Reviewed Original ResearchRecombinant tissue plasminogen activatorRecent gastrointestinal bleedingAcute ischemic strokeGastrointestinal malignanciesIschemic strokeGastrointestinal bleedingHospital mortalityIntravenous recombinant tissue plasminogen activatorOlder acute ischemic stroke patientsAcute ischemic stroke patientsRtPA-treated patientsIschemic stroke patientsTissue plasminogen activatorOutcomes of interestGuidelines-StrokeIndex strokeRecent bleedingSevere strokeObservational cohortClinical outcomesStroke patientsThrombolytic therapyBleedingSystemic hemorrhagePatients
2018
Diabetes 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
2017
Blood pressure and in-hospital outcomes in patients presenting with ischaemic stroke
Bangalore S, Schwamm L, Smith E, Hellkamp A, Suter R, Xian Y, Schulte P, Fonarow G, Bhatt D, Committee and Investigators F. Blood pressure and in-hospital outcomes in patients presenting with ischaemic stroke. European Heart Journal 2017, 38: 2827-2835. PMID: 28982227, PMCID: PMC5837595, DOI: 10.1093/eurheartj/ehx330.Peer-Reviewed Original ResearchConceptsMean arterial pressureSystolic blood pressureAcute ischemic strokeDiastolic blood pressureBlood pressureIschemic strokeShort-term outcomesHaemorrhagic complicationsThrombolytic therapyPulse pressureHospital outcomesAdmission diastolic blood pressureHigher systolic BP valuesPoor short-term outcomeHigher systolic blood pressureLower systolic blood pressureGuidelines-Stroke registryPost-stroke hypertensionLower blood pressureSystolic BP valuesOutcomes of interestAdmission systolicHospital mortalityHospital deathArterial pressure
2015
Lack of Impact of Electronic Health Records on Quality of Care and Outcomes for Ischemic Stroke
Joynt K, Bhatt D, Schwamm L, Xian Y, Heidenreich P, Fonarow G, Smith E, Neely M, Grau-Sepulveda M, Hernandez A. Lack of Impact of Electronic Health Records on Quality of Care and Outcomes for Ischemic Stroke. Journal Of The American College Of Cardiology 2015, 65: 1964-1972. PMID: 25953748, DOI: 10.1016/j.jacc.2015.02.059.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overElectronic Health RecordsFemaleHospital Bed CapacityHospital MortalityHospitals, TeachingHumansLength of StayMaleMiddle AgedOutcome Assessment, Health CarePatient DischargePractice Guidelines as TopicQuality of Health CareStrokeTime-to-TreatmentTissue Plasminogen ActivatorUnited StatesConceptsElectronic health recordsIschemic strokeGWTG-Stroke hospitalsHealth recordsBetter clinical outcomesLogistic regression analysisAmerican Hospital Association Annual SurveyQuality of careOutcomes of interestHigh-quality careGuidelines-StrokeHospital mortalityStroke centersClinical outcomesStroke careSimilar oddsHospital characteristicsOutcome measuresTimely careHospitalPatientsStudy periodCareU.S. hospitalsStroke