2021
Expedited and Comprehensive Management of Low-Risk TIA Patients in the Emergency Department is Safe and Less Costly
Garg A, Maran I, Amin H, Vlieks K, Neuschatz K, Coppola A, Poskus K, Johnson J, Davis M, Minja F, Schindler J, Sansing LH, Malhotra A, Jasne AS, Sharma R. Expedited and Comprehensive Management of Low-Risk TIA Patients in the Emergency Department is Safe and Less Costly. Journal Of Stroke And Cerebrovascular Diseases 2021, 30: 106016. PMID: 34325273, DOI: 10.1016/j.jstrokecerebrovasdis.2021.106016.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overClinical ProtocolsCost SavingsCost-Benefit AnalysisDecision Support TechniquesDelivery of Health Care, IntegratedEmergency Service, HospitalFeasibility StudiesFemaleHospital CostsHumansIschemic Attack, TransientLength of StayMaleMiddle AgedOutcome and Process Assessment, Health CarePredictive Value of TestsRetrospective StudiesRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeTriageConceptsLow-risk TIA patientsTransient ischemic attackTIA patientsEmergency roomAcademic comprehensive stroke centerSingle-center cohort studyPre-pathway groupComprehensive stroke centerClinical practice recommendationsLength of stayOutcomes of interestImpending strokeIschemic attackOutpatient echocardiogramRapid outpatientTIA admissionsEchocardiogram findingsEchocardiographic findingsStroke clinicCohort studyStroke centersNeurovascular eventsEmergency departmentFinal diagnosisHospital costsDrip-and-ship versus mothership for endovascular treatment of acute stroke: A comparative effectiveness analysis
Wu X, Wira C, Matouk C, Forman H, Gandhi D, Sanelli P, Schindler J, Malhotra A. Drip-and-ship versus mothership for endovascular treatment of acute stroke: A comparative effectiveness analysis. International Journal Of Stroke 2021, 17: 315-322. PMID: 33759645, DOI: 10.1177/17474930211008701.Peer-Reviewed Original ResearchConceptsComprehensive stroke centerPrimary stroke centerAcute stroke patientsNearest comprehensive stroke centerAcute strokeMothership strategyStroke centersStroke patientsPlace of onsetHealth benefitsMarkov decision-analytic modelComparative effectiveness analysisRecent medical literatureMultiple sensitivity analysesDecision analytic modelMothership modelPrimary outcomeEndovascular treatmentPrehospital triageSudden onsetPatientsMedical literatureStrokeShip strategyTarget population
2020
Stroke Code Presentations, Interventions, and Outcomes Before and During the COVID-19 Pandemic
Jasne AS, Chojecka P, Maran I, Mageid R, Eldokmak M, Zhang Q, Nystrom K, Vlieks K, Askenase M, Petersen N, Falcone GJ, Wira CR, Lleva P, Zeevi N, Narula R, Amin H, Navaratnam D, Loomis C, Hwang DY, Schindler J, Hebert R, Matouk C, Krumholz HM, Spudich S, Sheth KN, Sansing LH, Sharma R. Stroke Code Presentations, Interventions, and Outcomes Before and During the COVID-19 Pandemic. Stroke 2020, 51: 2664-2673. PMID: 32755347, PMCID: PMC7446978, DOI: 10.1161/str.0000000000000347.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBetacoronavirusBrain IschemiaCohort StudiesComorbidityConnecticutCoronary Artery DiseaseCoronavirus InfectionsCOVID-19DyslipidemiasEmergency Medical ServicesEthnicityFemaleHumansHypertensionIncomeInsurance, HealthIntracranial HemorrhagesMaleMedically UninsuredMiddle AgedOutcome and Process Assessment, Health CarePandemicsPneumonia, ViralRetrospective StudiesSARS-CoV-2Severity of Illness IndexStrokeSubstance-Related DisordersTelemedicineThrombectomyThrombolytic TherapyTime-to-TreatmentConceptsComprehensive stroke centerStroke codePatient characteristicsStroke severityStroke code patientsHistory of hypertensionStroke-like symptomsCoronary artery diseaseCoronavirus disease 2019 (COVID-19) pandemicPatient-level dataLower median household incomePublic health initiativesDisease 2019 pandemicCOVID-19 pandemicRace/ethnicityCode patientsHospital presentationPublic health insuranceRankin ScaleStroke centersArtery diseaseReperfusion timeStroke symptomsEarly outcomesConnecticut hospitals
2019
Decreases in Blood Pressure During Thrombectomy Are Associated With Larger Infarct Volumes and Worse Functional Outcome
Petersen NH, Ortega-Gutierrez S, Wang A, Lopez GV, Strander S, Kodali S, Silverman A, Zheng-Lin B, Dandapat S, Sansing LH, Schindler JL, Falcone GJ, Gilmore EJ, Amin H, Cord B, Hebert RM, Matouk C, Sheth KN. Decreases in Blood Pressure During Thrombectomy Are Associated With Larger Infarct Volumes and Worse Functional Outcome. Stroke 2019, 50: 1797-1804. PMID: 31159701, PMCID: PMC6787912, DOI: 10.1161/strokeaha.118.024286.Peer-Reviewed Original ResearchConceptsFinal infarct volumeWorse functional outcomeInfarct volumeEndovascular thrombectomyFunctional outcomeOcclusion strokeCerebral infarction 2b/3 reperfusionPressure reductionLarge vessel intracranial occlusionsGreater infarct growthBlood pressure reductionComprehensive stroke centerPercent of patientsBlood pressure managementLarger infarct volumesModified Rankin ScaleRankin Scale scoreMultivariable logistic regressionRelative hypotensionSustained hypotensionInfarct progressionNinety patientsInfarct growthIschemic penumbraIschemic stroke