2023
Association of Neighborhood-Level Socioeconomic Factors With Delay to Hospital Arrival in Patients With Acute Stroke
Forman R, Okumu R, Mageid R, Baker A, Neu D, Parker R, Peyravi R, Schindler J, Sansing L, Sheth K, de Havenon A, Jasne A, Narula R, Wira C, Warren J, Sharma R. Association of Neighborhood-Level Socioeconomic Factors With Delay to Hospital Arrival in Patients With Acute Stroke. Neurology 2023, 102: e207764. PMID: 38165368, PMCID: PMC10834135, DOI: 10.1212/wnl.0000000000207764.Peer-Reviewed Original ResearchConceptsEmergency department arrival timesEmergency medical servicesLate presentationAcute ischemic stroke therapyYale-New Haven HospitalGuidelines-Stroke registryNeighborhood-level socioeconomic factorsPatient-level factorsRetrospective observational studyIschemic stroke therapyMixed-effects logistic regression modelNon-white patientsNon-white raceUnivariate logistic regressionNew Haven HospitalLogistic regression modelsHospital presentationTreatment ineligibilityStroke RegistryAcute strokeHospital arrivalStroke therapyUnivariate analysisObservational studyPatients
2022
Bedside detection of intracranial midline shift using portable magnetic resonance imaging
Sheth KN, Yuen MM, Mazurek MH, Cahn BA, Prabhat AM, Salehi S, Shah JT, By S, Welch EB, Sofka M, Sacolick LI, Kim JA, Payabvash S, Falcone GJ, Gilmore EJ, Hwang DY, Matouk C, Gordon-Kundu B, RN AW, Petersen N, Schindler J, Gobeske KT, Sansing LH, Sze G, Rosen MS, Kimberly WT, Kundu P. Bedside detection of intracranial midline shift using portable magnetic resonance imaging. Scientific Reports 2022, 12: 67. PMID: 34996970, PMCID: PMC8742125, DOI: 10.1038/s41598-021-03892-7.Peer-Reviewed Original ResearchConceptsMidline shiftNeuroscience intensive care unitCare measurementYale-New Haven HospitalValuable bedside toolIntensive care unitPoor clinical outcomeBrain-injured patientsMass effectNew Haven HospitalMagnetic resonance imagingClinical outcomesIll patientsCare unitStroke patientsFunctional outcomeBedside toolObservational studyBedside detectionImaging examsPatientsResonance imagingPortable MRIImaging suiteSignificant concordance
2021
Portable, bedside, low-field magnetic resonance imaging for evaluation of intracerebral hemorrhage
Mazurek MH, Cahn BA, Yuen MM, Prabhat AM, Chavva IR, Shah JT, Crawford AL, Welch EB, Rothberg J, Sacolick L, Poole M, Wira C, Matouk CC, Ward A, Timario N, Leasure A, Beekman R, Peng TJ, Witsch J, Antonios JP, Falcone GJ, Gobeske KT, Petersen N, Schindler J, Sansing L, Gilmore EJ, Hwang DY, Kim JA, Malhotra A, Sze G, Rosen MS, Kimberly WT, Sheth KN. Portable, bedside, low-field magnetic resonance imaging for evaluation of intracerebral hemorrhage. Nature Communications 2021, 12: 5119. PMID: 34433813, PMCID: PMC8387402, DOI: 10.1038/s41467-021-25441-6.Peer-Reviewed Original ResearchConceptsMagnetic resonance imagingNIH Stroke ScaleIntracerebral hemorrhageHematoma volumeYale-New Haven HospitalStroke care pathwayConventional magnetic resonance imagingBoard-certified neuroradiologistsNew Haven HospitalResource-limited settingsStroke ScaleClinical outcomesLow-field magnetic resonance imagingCare pathwayLow-field magnetic resonanceRadiological examinationConventional neuroimagingAdvanced MRI technologiesResonance imagingCases of disagreementHemorrhageMRI technologyPortable MRINeuroimagingMagnetic resonance
2020
Assessment of Brain Injury Using Portable, Low-Field Magnetic Resonance Imaging at the Bedside of Critically Ill Patients
Sheth KN, Mazurek MH, Yuen MM, Cahn BA, Shah JT, Ward A, Kim JA, Gilmore EJ, Falcone GJ, Petersen N, Gobeske KT, Kaddouh F, Hwang DY, Schindler J, Sansing L, Matouk C, Rothberg J, Sze G, Siner J, Rosen MS, Spudich S, Kimberly WT. Assessment of Brain Injury Using Portable, Low-Field Magnetic Resonance Imaging at the Bedside of Critically Ill Patients. JAMA Neurology 2020, 78: 41-47. PMID: 32897296, PMCID: PMC7489395, DOI: 10.1001/jamaneurol.2020.3263.Peer-Reviewed Original ResearchIntensive care unit roomsIntensive care settingBrain injuryCare settingsIll patientsNeurological injuryT2 fluid-attenuated inversion recoveryCOVID-19Intensive care unit admissionSingle-center cohort studyIntensive care unit settingUnit roomsYale-New Haven HospitalNasopharyngeal swab resultsCare unit admissionSingle-center seriesBrain imaging findingsIntensive care unitFluid-attenuated inversion recoveryDiffusion-weighted imaging sequencesTraumatic brain injuryClinical care settingsNew Haven HospitalMagnetic resonance imagingConventional magnetic resonance imaging (MRI) system
2016
Validation of TURN, a simple predictor of symptomatic intracerebral hemorrhage after IV thrombolysis
Asuzu D, Nystrӧm K, Amin H, Schindler J, Wira C, Greer D, Fang NF, Halliday J, Sheth KN. Validation of TURN, a simple predictor of symptomatic intracerebral hemorrhage after IV thrombolysis. Clinical Neurology And Neurosurgery 2016, 146: 71-75. PMID: 27152469, DOI: 10.1016/j.clineuro.2016.04.017.Peer-Reviewed Original ResearchConceptsSymptomatic intracerebral hemorrhageIntracerebral hemorrhageRt-PAOdds ratioYale-New Haven HospitalNINDS rt-PA trialIschemic stroke patientsNew Haven HospitalTwo-sample t-testStroke patientsCharacteristic curveThrombolysisHemorrhageSignificant differencesPatientsT-testScoresExternal datasetSimple predictorInternal datasetHospital
2015
TURN: A Simple Predictor of Symptomatic Intracerebral Hemorrhage After IV Thrombolysis
Asuzu D, Nyström K, Amin H, Schindler J, Wira C, Greer D, Chi NF, Halliday J, Sheth KN. TURN: A Simple Predictor of Symptomatic Intracerebral Hemorrhage After IV Thrombolysis. Neurocritical Care 2015, 23: 166-171. PMID: 25869481, DOI: 10.1007/s12028-015-0131-z.Peer-Reviewed Original ResearchConceptsSymptomatic intracerebral hemorrhageBaseline NIHSS scorePrestroke mRS scoreNIHSS scoreMRS scoreIntracerebral hemorrhageRt-PAOdds ratioYale-New Haven HospitalNINDS rt-PA trialIschemic stroke patientsIschemic stroke treatmentIndependent predictorsStroke treatmentStroke patientsClinical parametersPlatelet countHyperacute strokeDerivation datasetThrombolysisLogistic regressionSubstantial riskNew scoreCharacteristic curveHemorrhage
2014
Modest Association between the Discharge Modified Rankin Scale Score and Symptomatic Intracerebral Hemorrhage after Intravenous Thrombolysis
Asuzu D, Nystrom K, Amin H, Schindler J, Wira C, Greer D, Fang NF, Halliday J, Sheth KN. Modest Association between the Discharge Modified Rankin Scale Score and Symptomatic Intracerebral Hemorrhage after Intravenous Thrombolysis. Journal Of Stroke And Cerebrovascular Diseases 2014, 24: 548-553. PMID: 25540072, DOI: 10.1016/j.jstrokecerebrovasdis.2014.09.034.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, IntravenousArea Under CurveBrain IschemiaCerebral HemorrhageChi-Square DistributionConnecticutDecision Support TechniquesDisability EvaluationFemaleFibrinolytic AgentsHumansLogistic ModelsMaleOdds RatioPatient DischargePredictive Value of TestsRetrospective StudiesRisk AssessmentRisk FactorsROC CurveStrokeThrombolytic TherapyTime FactorsTreatment OutcomeConceptsDischarge mRS scoreSymptomatic intracerebral hemorrhageRankin Scale scoreMRS scoreClinical scoresAdverse outcomesIntracerebral hemorrhageScale scoreModified Rankin Scale scoreLong-term adverse outcomesYale-New Haven HospitalIntravenous thrombolytic therapyIschemic stroke patientsUnivariate logistic regressionHosmer-Lemeshow statisticNew Haven HospitalMRS dataIntravenous thrombolysisThrombolytic therapyStroke patientsClinical benefitModest agreementClinical dataLogistic regressionModest associationComparison of 8 Scores for predicting Symptomatic Intracerebral Hemorrhage after IV Thrombolysis
Asuzu D, Nystrom K, Amin H, Schindler J, Wira C, Greer D, Chi NF, Halliday J, Sheth KN. Comparison of 8 Scores for predicting Symptomatic Intracerebral Hemorrhage after IV Thrombolysis. Neurocritical Care 2014, 22: 229-233. PMID: 25168743, DOI: 10.1007/s12028-014-0060-2.Peer-Reviewed Original ResearchConceptsSymptomatic intracerebral hemorrhageRt-PA therapyStroke-TPIThrombolytic therapyClinical scoresIntracerebral hemorrhageOdds ratioPredictors of sICHAcute ischemic stroke patientsYale-New Haven HospitalRt-PA treatmentIschemic stroke patientsHosmer-Lemeshow statisticBackgroundIntracerebral hemorrhageConsecutive patientsFeared complicationMethodsClinical dataStroke patientsAdverse outcomesStudy criteriaPatientsTherapyHemorrhageLogistic regressionSPAN-100
2012
Missed Opportunities for Recognition of Ischemic Stroke in the Emergency Department
Lever NM, Nyström KV, Schindler JL, Halliday J, Wira C, Funk M. Missed Opportunities for Recognition of Ischemic Stroke in the Emergency Department. Journal Of Emergency Nursing 2012, 39: 434-439. PMID: 22633790, DOI: 10.1016/j.jen.2012.02.011.Peer-Reviewed Original ResearchConceptsNontraditional symptomsIschemic strokeEmergency departmentSymptom presentationDiagnostic accuracyYale-New Haven HospitalComprehensive neurological evaluationGeneralized weaknessNeurological evaluationStroke symptomsMedical recordsMental statusEmergency nursesPatientsAppropriate managementSymptomsStrokeDiagnosisStrong associationSymptom typeHospitalPresentationMissed opportunityDescriptive statisticsAssociation