2024
Contemporary Prestroke Dual Antiplatelet Use and Symptomatic Intracerebral Hemorrhage Risk After Thrombolysis
Peng T, Schwamm L, Fonarow G, Hassan A, Hill M, Messé S, Coronado F, Falcone G, Sharma R. Contemporary Prestroke Dual Antiplatelet Use and Symptomatic Intracerebral Hemorrhage Risk After Thrombolysis. JAMA Neurology 2024, 81: 722-731. PMID: 38767894, PMCID: PMC11106713, DOI: 10.1001/jamaneurol.2024.1312.Peer-Reviewed Original ResearchRisk of symptomatic intracerebral hemorrhageSymptomatic intracerebral hemorrhageTreated with IV-tPAAcute ischemic strokeIV-tPAAmerican Heart Association and American Stroke AssociationAssociated with lower oddsIschemic strokeDual antiplatelet therapyAssociated with increased riskPropensity score subclassificationAmerican Stroke AssociationIntracerebral hemorrhage riskGWTG-StrokeSymptomatic intracerebral hemorrhage riskGuidelines-StrokeDischarge modified Rankin Scale scoreIn-hospital deathStroke AssociationLower oddsRate of symptomatic intracerebral hemorrhageAntiplatelet therapyCohort studyAssociated with symptomatic intracerebral hemorrhagePrestroke
2022
Analysis of Prescriptions for Dual Antiplatelet Therapy After Acute Ischemic Stroke
Xian Y, Xu H, Matsouaka R, Laskowitz D, Maisch L, Hannah D, Smith E, Fonarow G, Bhatt D, Schwamm L, Mac Grory B, Feng W, Fosbøl E, Peterson E, Johnson M. Analysis of Prescriptions for Dual Antiplatelet Therapy After Acute Ischemic Stroke. JAMA Network Open 2022, 5: e2224157. PMID: 35900761, PMCID: PMC9335137, DOI: 10.1001/jamanetworkopen.2022.24157.Peer-Reviewed Original ResearchConceptsAHA/ASA guidelinesAcute ischemic strokeMinor ischemic strokeUse of DAPTDual antiplatelet therapyIschemic strokeMinor strokeHospital-level variationAntiplatelet therapyASA guidelinesDAPT useCohort studySecondary preventionOdds ratioAmerican Heart Association/American Stroke AssociationMinor acute ischemic strokeMulticenter retrospective cohort studyMultivariable logistic regression analysisSubstantial hospital-level variationAHA/ASAGuidelines-Stroke programIdentical clinical featuresRetrospective cohort studyAmerican Stroke AssociationEvidence-based guidelinesTrends in Use, Outcomes, and Disparities in Endovascular Thrombectomy in US Patients With Stroke Aged 80 Years and Older Compared With Younger Patients
Adcock A, Schwamm L, Smith E, Fonarow G, Reeves M, Xu H, Matsouaka R, Xian Y, Saver J. Trends in Use, Outcomes, and Disparities in Endovascular Thrombectomy in US Patients With Stroke Aged 80 Years and Older Compared With Younger Patients. JAMA Network Open 2022, 5: e2215869. PMID: 35671055, PMCID: PMC9175073, DOI: 10.1001/jamanetworkopen.2022.15869.Peer-Reviewed Original ResearchConceptsSymptomatic intracranial hemorrhageAcute ischemic strokeYounger patientsHospital mortalityCohort studyIschemic strokeOlder patientsIntracranial hemorrhageAmerican Heart Association/American Stroke AssociationFunctional independenceHealth Stroke Scale scoreSymptomatic intracranial hemorrhage rateNationwide retrospective cohort studyGuidelines-Stroke programGWTG-Stroke hospitalsIntracranial hemorrhage rateStroke Scale scoreFavorable functional outcomeRetrospective cohort studyAmerican Stroke AssociationQuality improvement registryMeeting study criteriaEVT rateEVT useThrombectomy trials
2021
Recommendations for Regional Stroke Destination Plans in Rural, Suburban, and Urban Communities From the Prehospital Stroke System of Care Consensus Conference: A Consensus Statement From the American Academy of Neurology, American Heart Association/American Stroke Association, American Society of Neuroradiology, National Association of EMS Physicians, National Association of State EMS Officials, Society of NeuroInterventional Surgery, and Society of Vascular and Interventional Neurology: Endorsed by the Neurocritical Care Society
Jauch E, Schwamm L, Panagos P, Barbazzeni J, Dickson R, Dunne R, Foley J, Fraser J, Lassers G, Martin-Gill C, O’Brien S, Pinchalk M, Prabhakaran S, Richards C, Taillac P, Tsai A, Yallapragada A, Conference O. Recommendations for Regional Stroke Destination Plans in Rural, Suburban, and Urban Communities From the Prehospital Stroke System of Care Consensus Conference: A Consensus Statement From the American Academy of Neurology, American Heart Association/American Stroke Association, American Society of Neuroradiology, National Association of EMS Physicians, National Association of State EMS Officials, Society of NeuroInterventional Surgery, and Society of Vascular and Interventional Neurology: Endorsed by the Neurocritical Care Society. Stroke 2021, 52: e133-e152. PMID: 33691507, DOI: 10.1161/strokeaha.120.033228.Peer-Reviewed Original ResearchConceptsAmerican Heart Association/American Stroke AssociationSociety of VascularAmerican Stroke AssociationNeurocritical Care SocietyState EMS OfficialsInterventional NeurologyStroke AssociationStroke systemsConsensus statementConsensus conferenceNeurointerventional surgeryAmerican AcademyEMS physiciansAmerican SocietyNeurologyAssociationNational AssociationUrban communitiesSurgeryVascular
2019
Recommendations for the Establishment of Stroke Systems of Care: A 2019 Update: A Policy Statement From the American Stroke Association
Adeoye O, Nyström K, Yavagal D, Luciano J, Nogueira R, Zorowitz R, Khalessi A, Bushnell C, Barsan W, Panagos P, Alberts M, Tiner A, Schwamm L, Jauch E. Recommendations for the Establishment of Stroke Systems of Care: A 2019 Update: A Policy Statement From the American Stroke Association. Stroke 2019, 50: e187-e210. PMID: 31104615, DOI: 10.1161/str.0000000000000173.Peer-Reviewed Original ResearchConceptsAmerican Stroke AssociationStroke systemsStroke AssociationStroke center certificationMobile stroke unitEmergency medical servicesHospital dischargeSecondary preventionStroke centersEndovascular therapyStroke unitPrimary preventionCenter certificationNeurocritical careAssociation recommendationsCareBasis of improvementStroke recognitionMedical servicesHealthcare agenciesScientific evidenceHealthcare policyAppropriate facilitiesPreventionSignificant changesComparison 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
2017
Incorporating Stroke Severity Into Hospital Measures of 30-Day Mortality After Ischemic Stroke Hospitalization
Schwartz J, Wang Y, Qin L, Schwamm LH, Fonarow GC, Cormier N, Dorsey K, McNamara RL, Suter LG, Krumholz HM, Bernheim SM. Incorporating Stroke Severity Into Hospital Measures of 30-Day Mortality After Ischemic Stroke Hospitalization. Stroke 2017, 48: 3101-3107. PMID: 28954922, DOI: 10.1161/strokeaha.117.017960.Peer-Reviewed Original ResearchConceptsRisk-standardized mortality ratesElectronic health record dataHealth record dataStroke severityClaims dataMortality rateAmerican Heart Association/American Stroke AssociationHealth Stroke Scale scoreRisk variablesMedicaid ServicesRisk adjustmentMedian risk-standardized mortality rateGuidelines-Stroke registryLow-mortality hospitalsStroke Scale scoreAcute ischemic strokeAmerican Stroke AssociationOdds of mortalityMortality measuresRecord dataIschemic stroke hospitalizationsHigh-mortality hospitalsService claims dataRisk-adjustment variablesHospital admissionCoexistent Sickle Cell Disease Has No Impact on the Safety or Outcome of Lytic Therapy in Acute Ischemic Stroke
Adams R, Cox M, Ozark S, Kanter J, Schulte P, Xian Y, Fonarow G, Smith E, Schwamm L. Coexistent Sickle Cell Disease Has No Impact on the Safety or Outcome of Lytic Therapy in Acute Ischemic Stroke. Stroke 2017, 48: 686-691. PMID: 28183857, DOI: 10.1161/strokeaha.116.015412.Peer-Reviewed Original ResearchConceptsSickle cell diseaseAcute ischemic strokeIschemic strokeThrombolytic therapyCell diseaseMultivariable logistic regression modelAdmission National InstitutesGuidelines-Stroke registrySymptomatic intracranial hemorrhageHealth Stroke ScaleIntracranial hemorrhage rateAmerican Stroke AssociationAmerican Heart AssociationNational Heart LungNational InstituteLogistic regression modelsLytic therapyStroke ScaleTPA useBlood pressureDischarge outcomesHemorrhage rateStroke patientsBlood InstituteExchange transfusion
2014
Stroke Outcomes Measures Must Be Appropriately Risk Adjusted to Ensure Quality Care of Patients
Fonarow G, Alberts M, Broderick J, Jauch E, Kleindorfer D, Saver J, Solis P, Suter R, Schwamm L. Stroke Outcomes Measures Must Be Appropriately Risk Adjusted to Ensure Quality Care of Patients. Stroke 2014, 45: 1589-1601. PMID: 24523036, DOI: 10.1161/str.0000000000000014.Peer-Reviewed Original ResearchConceptsAmerican Heart Association/American Stroke AssociationAmerican Stroke AssociationStroke Outcome MeasureOutcome measuresAdequate risk adjustmentIschemic strokeStroke patientsStroke AssociationAcute ischemic stroke patientsMedicaid ServicesRisk adjustmentHealth Stroke ScaleHospital-level outcomesAcute ischemic strokeIschemic stroke patientsEvidence-based careCause of deathStroke severity measuresRisk-adjusted outcome measuresStroke ScaleStroke careStroke mortalityReadmission measuresPatientsCase mix
2013
Teleneurology applications
Wechsler L, Tsao J, Levine S, Swain-Eng R, Adams R, Demaerschalk B, Hess D, Moro E, Schwamm L, Steffensen S, Stern B, Zuckerman S, Bhattacharya P, Davis L, Yurkiewicz I, Alphonso A. Teleneurology applications. Neurology 2013, 80: 670-676. PMID: 23400317, PMCID: PMC3590056, DOI: 10.1212/wnl.0b013e3182823361.Peer-Reviewed Original ResearchConceptsNeurologic careAcute stroke assessmentAmerican Stroke AssociationPrimary care physiciansFederal health care policyExpansion of telemedicineHealth care policyNeurology specialistsCare physiciansPhysician awarenessStroke AssociationSpecialty careNeurology practiceStroke assessmentAmerican AcademyPatient careNeurologistsCareTeleneurologyCare policyUnderserved communitiesRural areasUnderserved locationsPrimary studiesCurrent literature
2012
Implementing a State-based Stroke Quality Improvement Collaborative
O’Neill H, Coe L, Magdon-Ismail Z, Schwamm L. Implementing a State-based Stroke Quality Improvement Collaborative. Critical Pathways In Cardiology A Journal Of Evidence-Based Medicine 2012, 11: 114-122. PMID: 22825531, DOI: 10.1097/hpc.0b013e31825e12a6.Peer-Reviewed Original ResearchConceptsStroke quality improvementService hospitalsAmerican Heart Association/American Stroke AssociationHealthcare Improvement collaborative modelAcute stroke careAmerican Stroke AssociationNational clinical guidelinesQuality Improvement CollaborativeClinical quality improvementCase entryHospital quality improvementStroke careStroke AssociationClinical guidelinesHospital representativesPatient careStroke dischargesHospitalMassachusetts DepartmentQuality improvementHospital fundingPublic healthConsistent participationDescriptive statisticsCollaborative modelGet With The Guidelines Stroke Performance Indicators in a Brazilian Tertiary Hospital
de Carvalho F, Schwamm L, Kuster G, Alves M, Neto M, Silva G. Get With The Guidelines Stroke Performance Indicators in a Brazilian Tertiary Hospital. Cerebrovascular Diseases Extra 2012, 2: 26-35. PMID: 22811686, PMCID: PMC3398824, DOI: 10.1159/000339578.Peer-Reviewed Original ResearchDeep vein thrombosis prophylaxisGWTG-Stroke programEligible patientsBrazilian tertiary hospitalThrombosis prophylaxisAntithrombotic medicationStroke ProgramSymptom onsetTertiary hospitalAtrial fibrillationSmoking cessationDischarge useNational Cholesterol Education Program Adult Treatment Panel III guidelinesAmerican Heart Association/American Stroke AssociationAdult Treatment Panel III guidelinesAdult long-term disabilityTissue plasminogen activator useAntithrombotic medication useNCEP III guidelinesStroke quality improvementTransient ischemic attackAcute ischemic strokeAmerican Stroke AssociationClinical practice guidelinesLong-term disability
2011
Improving Door-to-Needle Times in Acute Ischemic Stroke
Fonarow G, Smith E, Saver J, Reeves M, Hernandez A, Peterson E, Sacco R, Schwamm L. Improving Door-to-Needle Times in Acute Ischemic Stroke. Stroke 2011, 42: 2983-2989. PMID: 21885841, DOI: 10.1161/strokeaha.111.621342.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeAcute ischemic stroke patientsTissue-type plasminogen activatorIschemic stroke patientsNeedle timeIschemic strokeStroke patientsAmerican Heart Association/American Stroke AssociationIntravenous tissue-type plasminogen activatorAmerican Stroke AssociationUnited States hospitalsEmergency medical services prenotificationInitial program goalsTeam-based approachImproving DoorStroke teamTPA administrationFaster doorStroke AssociationClinical practiceHospital participationState HospitalStrokePatientsPlasminogen activator
2010
Hospital Certification for Optimizing Cardiovascular Disease and Stroke Quality of Care and Outcomes
Fonarow G, Gregory T, Driskill M, Stewart M, Beam C, Butler J, Jacobs A, Meltzer N, Peterson E, Schwamm L, Spertus J, Yancy C, Tomaselli G, Sacco R. Hospital Certification for Optimizing Cardiovascular Disease and Stroke Quality of Care and Outcomes. Circulation 2010, 122: 2459-2469. PMID: 21098429, DOI: 10.1161/cir.0b013e3182011a81.Peer-Reviewed Original ResearchConceptsAmerican Heart Association/American Stroke AssociationAmerican Stroke AssociationCardiovascular diseaseStroke AssociationStroke qualityEvidence-based careStroke patientsLeading causeCurrent evidenceHospital accreditationStrokeDiseaseHealthcare expendituresHospital certificationCareOutcomesPatientsFuture strategiesAssociationHealthcare organizationsHospitalMixed findingsMortalityRisk of Thrombolytic Therapy for Acute Ischemic Stroke in Patients With Current Malignancy
Masrur S, Abdullah A, Smith E, Hidalgo R, El-Ghandour A, Rordorf G, Schwamm L. Risk of Thrombolytic Therapy for Acute Ischemic Stroke in Patients With Current Malignancy. Journal Of Stroke And Cerebrovascular Diseases 2010, 20: 124-130. PMID: 20598579, DOI: 10.1016/j.jstrokecerebrovasdis.2009.10.010.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBostonBrain IschemiaChi-Square DistributionComorbidityFemaleFibrinolytic AgentsHospital MortalityHumansIntracranial HemorrhagesLogistic ModelsMaleNeoplasmsOdds RatioRetrospective StudiesRisk AssessmentRisk FactorsStrokeThrombolytic TherapyTissue Plasminogen ActivatorTreatment OutcomeConceptsIntra-arterial therapyTissue plasminogen activatorSymptomatic intracranial hemorrhageCurrent malignancyHospital mortalityMedical comorbiditiesThrombolytic therapyIntracranial hemorrhageIndependent predictorsAIS patientsIntravenous (IV) tPAHealth Stroke Scale scoreStroke Scale scoreAcute ischemic strokeConsecutive AIS patientsHistory of hypertensionHistory of malignancyAmerican Stroke AssociationOnly independent predictorRisks of thrombolysisMost clinical trialsStepwise logistic regressionBrain metastasesIschemic strokePerformance statusTranslating Evidence Into Practice: A Decade of Efforts by the American Heart Association/American Stroke Association to Reduce Death and Disability Due to Stroke
Schwamm L, Fayad P, Acker J, Duncan P, Fonarow G, Girgus M, Goldstein L, Gregory T, Kelly-Hayes M, Sacco R, Saver J, Segrest W, Solis P, Yancy C. Translating Evidence Into Practice: A Decade of Efforts by the American Heart Association/American Stroke Association to Reduce Death and Disability Due to Stroke. Stroke 2010, 41: 1051-1065. PMID: 20181677, DOI: 10.1161/str.0b013e3181d2da7d.Peer-Reviewed Original Research