2024
Twenty Years of Sustained Improvement in Quality of Care and Outcomes for Patients Hospitalized With Stroke or Transient Ischemic Attack: Data From The Get With The Guidelines-Stroke Program
Xian Y, Li S, Jiang T, Beon C, Poudel R, Thomas K, Reeves M, Smith E, Saver J, Sheth K, Messé S, Schwamm L, Fonarow G. Twenty Years of Sustained Improvement in Quality of Care and Outcomes for Patients Hospitalized With Stroke or Transient Ischemic Attack: Data From The Get With The Guidelines-Stroke Program. Stroke 2024, 55: 2599-2610. PMID: 39429153, PMCID: PMC11518659, DOI: 10.1161/strokeaha.124.048174.Peer-Reviewed Original ResearchConceptsGuidelines-Stroke programEvidence-based stroke careDoor-to-needle timeTransient ischemic attackGuidelines-Stroke hospitalsEvidence-based careQuality of careSmoking cessation counselingSustained improvementQuality improvement initiativesSkilled nursing facilityIndependence of patientsAcute ischemic strokeIschemic strokeRelevant to patientsIschemic attackDoor-to-puncture timeCessation counselingGuidelines-StrokeAssociated with sustained improvementStroke careDysphagia screeningNursing facilitiesHospital characteristicsImprovement initiatives
2023
Smoking-Cessation Pharmacotherapy After Stroke and Transient Ischemic Attack: A Get With The Guidelines-Stroke Analysis
Parikh N, Zhang C, Omran S, Restifo D, Carpenter M, Schwamm L, Kamel H. Smoking-Cessation Pharmacotherapy After Stroke and Transient Ischemic Attack: A Get With The Guidelines-Stroke Analysis. Stroke 2023, 54: e63-e65. PMID: 36727507, PMCID: PMC9992306, DOI: 10.1161/strokeaha.122.041532.Peer-Reviewed Original Research
2022
Trends in characteristics of neurologists who provide stroke consultations in the USA, 2008–2021
Nakamoto C, Wilcock A, Schwamm L, Majersik J, Zachrison K, Mehrotra A. Trends in characteristics of neurologists who provide stroke consultations in the USA, 2008–2021. Stroke And Vascular Neurology 2022, 8: 86-88. PMID: 35902139, PMCID: PMC9985800, DOI: 10.1136/svn-2022-001662.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeTransient ischemic attackVascular neurologistsPatient's homeAIS/transient ischemic attackHigh-volume providersNeurologist consultationTIA episodesIschemic attackIschemic strokeStroke consultationsNeurologistsService MedicarePhysician practicesStudy periodConsultsPatientsEpisodesConsultationHomeHospitalStrokeProportion
2021
Association of Hospital Telestroke Adoption With Changes in Initial Hospital Presentation and Transfers Among Patients With Stroke and Transient Ischemic Attacks
Zachrison K, Richard J, Wilcock A, Zubizaretta J, Schwamm L, Uscher-Pines L, Mehrotra A. Association of Hospital Telestroke Adoption With Changes in Initial Hospital Presentation and Transfers Among Patients With Stroke and Transient Ischemic Attacks. JAMA Network Open 2021, 4: e2126612. PMID: 34554236, PMCID: PMC8461501, DOI: 10.1001/jamanetworkopen.2021.26612.Peer-Reviewed Original ResearchConceptsHospital stroke volumeControl hospitalsStroke volumeStroke centersStroke symptomsStroke systemsCase mixTransient ischemic attack admissionsHospital pairsInitial hospital presentationThrombectomy-capable hospitalsComprehensive stroke centerTransient ischemic attackPrimary stroke centerCross-sectional studyMajor teaching hospitalObserved patient characteristicsBed sizeHospital presentationIschemic attackInitial hospitalCritical access hospitalsPatient characteristicsInterhospital transferPostimplementation periodClinical Characteristics, Management, and In-Hospital Outcomes in Patients With Stroke or Transient Ischemic Attack in China
Gu H, Yang X, Wang C, Zhao X, Wang Y, Liu L, Meng X, Jiang Y, Li H, Liu C, Wangqin R, Fonarow G, Schwamm L, Xian Y, Li Z, Wang Y. Clinical Characteristics, Management, and In-Hospital Outcomes in Patients With Stroke or Transient Ischemic Attack in China. JAMA Network Open 2021, 4: e2120745. PMID: 34387677, PMCID: PMC8363916, DOI: 10.1001/jamanetworkopen.2021.20745.Peer-Reviewed Original ResearchConceptsTransient ischemic attackChinese Stroke Center AllianceMajor adverse cardiovascular eventsHospital clinical outcomesQuality improvement studyIschemic strokeIntracerebral hemorrhageIschemic attackClinical characteristicsClinical outcomesPoor outcomeIntravenous recombinant tissue plasminogen activatorTemporal improvementRecombinant tissue plasminogen activatorAdverse cardiovascular eventsIn-Hospital OutcomesUse of anticoagulantsComposite scoreImprovement studyTissue plasminogen activatorMean composite scoreHealth care systemHospital complicationsTIA admissionsTIA care
2020
Disease Burden Following Non-Cardioembolic Minor Ischemic Stroke or High-Risk TIA: A GWTG-Stroke Study
Kaufman B, Shah S, Hellkamp A, Lytle B, Fonarow G, Schwamm L, Lesén E, Hedberg J, Tank A, Fita E, Bhalla N, Atreja N, Bettger J. Disease Burden Following Non-Cardioembolic Minor Ischemic Stroke or High-Risk TIA: A GWTG-Stroke Study. Journal Of Stroke And Cerebrovascular Diseases 2020, 29: 105399. PMID: 33254370, DOI: 10.1016/j.jstrokecerebrovasdis.2020.105399.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCost-Benefit AnalysisFee-for-Service PlansFemaleFunctional StatusHealth Care CostsHealth Services Needs and DemandHealth Services ResearchHospital CostsHumansIschemic Attack, TransientMaleMedicarePatient DischargeRegistriesRisk AssessmentRisk FactorsSeverity of Illness IndexStrokeTime FactorsTreatment OutcomeUnited StatesConceptsHigh-risk transient ischemic attackTransient ischemic attackMinor ischemic strokeIschemic strokeHigh-risk TIA patientsLimited real-world dataMedicare paymentsBurden of illnessClinical trial populationsMean Medicare paymentsImportant unmet needMedicare spendingIschemic attackTIA patientsAntiplatelet therapyIndex hospitalizationStroke RegistryComposite outcomeCumulative incidenceClinical outcomesTherapeutic optionsTrial populationFunctional statusDisease burdenPatient outcomesTrends Among Rural and Urban Medicare Beneficiaries in Care Delivery and Outcomes for Acute Stroke and Transient Ischemic Attacks, 2008-2017
Wilcock A, Zachrison K, Schwamm L, Uscher-Pines L, Zubizarreta J, Mehrotra A. Trends Among Rural and Urban Medicare Beneficiaries in Care Delivery and Outcomes for Acute Stroke and Transient Ischemic Attacks, 2008-2017. JAMA Neurology 2020, 77: 863-871. PMID: 32364573, PMCID: PMC7358912, DOI: 10.1001/jamaneurol.2020.0770.Peer-Reviewed Original ResearchConceptsTransient ischemic attackAcute ischemic strokeIschemic attackAcute strokeStroke centersRural-urban disparitiesResidential zip codeIschemic strokeEnd-stage kidney diseaseRural-Urban Commuting Area codesDescriptive observational studyHealth care centersUrban Medicare beneficiariesQuality of careTraditional MedicareNeurologist evaluationOutcome patientsUrban patientsStroke careNeurology consultationKidney diseaseMean ageCare centerStroke systemsObservational studyEvaluation of stroke incidence with duty‐cycled multielectrode‐phased radiofrequency ablation of persistent atrial fibrillation results of the VICTORY AF Study
Hummel J, Verma A, Calkins H, Schwamm L, Gress D, Wells D, Souza J, Hokanson R, Hemingway L, Stromberg K, Hoyt R, Wickliffe A, DeLurgio D, Boersma L. Evaluation of stroke incidence with duty‐cycled multielectrode‐phased radiofrequency ablation of persistent atrial fibrillation results of the VICTORY AF Study. Journal Of Cardiovascular Electrophysiology 2020, 31: 1289-1297. PMID: 32270538, DOI: 10.1111/jce.14483.Peer-Reviewed Original ResearchConceptsDevice-related strokesAcute procedural successAtrial fibrillationAF trialSecondary outcomesStroke incidenceProcedural successAF studyStroke/transient ischemic attackVitamin K antagonist anticoagulationMajor structural heart diseasePulmonary vein stenosisTransient ischemic attackIncidence of strokeStructural heart diseaseNumber of patientsVitamin K antagonismAtrial fibrillation resultsRigorous clinical evaluationIDE trialIschemic attackNeurologist assessmentPersAF patientsAF burdenPV stenosis
2019
Intravenous Tissue Plasminogen Activator in Stroke Mimics
Ali-Ahmed F, Federspiel J, Liang L, Xu H, Sevilis T, Hernandez A, Kosinski A, Prvu Bettger J, Smith E, Bhatt D, Schwamm L, Fonarow G, Peterson E, Xian Y. Intravenous Tissue Plasminogen Activator in Stroke Mimics. Circulation Cardiovascular Quality And Outcomes 2019, 12: e005609. PMID: 31412730, PMCID: PMC6699639, DOI: 10.1161/circoutcomes.119.005609.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, IntravenousAdultAgedAged, 80 and overBrain IschemiaDiagnosis, DifferentialFemaleFibrinolytic AgentsHumansIntracranial HemorrhagesMaleMiddle AgedPredictive Value of TestsRegistriesRisk AssessmentRisk FactorsStrokeThrombolytic TherapyTissue Plasminogen ActivatorTreatment OutcomeUnited StatesUnnecessary ProceduresConceptsTransient ischemic attackStroke mimicsIschemic strokeIschemic attackPrior stroke/transient ischemic attackStroke/transient ischemic attackIntravenous tissue plasminogen activatorGuidelines-Stroke registrySymptomatic intracranial hemorrhageCardiovascular risk factorsHealth Stroke ScaleHospital mortality rateAcute ischemic strokeStroke-like symptomsTissue plasminogen activatorUse of tPANonstroke diagnosisThrombolysis safetyIntravenous tPAStroke ScaleComplication rateIntracranial hemorrhagePresumed strokeRisk factorsFunctional disordersRelation of Admission Blood Pressure to In-hospital and 90-Day Outcomes in Patients Presenting With Transient Ischemic Attack
Bangalore S, Schwamm L, Smith E, Hellkamp A, Xian Y, Schulte P, Saver J, Fonarow G, Bhatt D, Committee and Investigators F. Relation of Admission Blood Pressure to In-hospital and 90-Day Outcomes in Patients Presenting With Transient Ischemic Attack. The American Journal Of Cardiology 2019, 123: 1083-1095. PMID: 30685057, DOI: 10.1016/j.amjcard.2018.12.037.Peer-Reviewed Original ResearchConceptsTransient ischemic attackSystolic blood pressureAdmission blood pressureDiastolic blood pressureMean arterial pressureBlood pressureIschemic attackPulse pressureHospital outcomesPostdischarge outcomesArterial pressureLower admission systolic blood pressureAdmission systolic blood pressureHigher admission blood pressureLower systolic blood pressureGuidelines-Stroke registryMajor cardiovascular eventsAdmission systolicPostdischarge mortalityCardiovascular eventsCardiovascular readmissionHospital deathInverse associationHigh riskPatients
2018
Rates, Characteristics, and Outcomes of Patients Transferred to Specialized Stroke Centers for Advanced Care
Ali S, Fonarow G, Liang L, Xian Y, Smith E, Bhatt D, Schwamm L. Rates, Characteristics, and Outcomes of Patients Transferred to Specialized Stroke Centers for Advanced Care. Circulation Cardiovascular Quality And Outcomes 2018, 11: e003359. PMID: 30354551, DOI: 10.1161/circoutcomes.116.003359.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCentralized Hospital ServicesDisability EvaluationFemaleHealthcare DisparitiesHospital MortalityHumansMaleMiddle AgedPatient AdmissionPatient TransferRecovery of FunctionRegistriesRetrospective StudiesRisk AssessmentRisk FactorsStrokeTime FactorsTime-to-TreatmentTreatment OutcomeUnited StatesConceptsSpecialized stroke centersStroke centersHospital mortalityAIS casesPrevious stroke/transient ischemic attackStroke/transient ischemic attackHealth Stroke Scale scoreHigher median National InstitutesWorse short-term outcomesAcute ischemic stroke careGuidelines-Stroke registryMedian National InstitutesOutcomes of patientsStroke Scale scoreTransient ischemic attackShort-term outcomesIschemic stroke careTransfer of patientsMidwest teaching hospitalInstitutional mortality ratesIschemic attackMultivariable adjustmentBaseline characteristicsRankin ScaleClinical outcomesImplementation of a Rapid, Protocol-based TIA Management Pathway
Jarhult S, Howell M, Barnaure-Nachbar I, Chang Y, White B, Amatangelo M, Brown D, Singhal A, Schwamm L, Silverman S, Goldstein J. Implementation of a Rapid, Protocol-based TIA Management Pathway. Western Journal Of Emergency Medicine 2018, 19: 216-223. PMID: 29560046, PMCID: PMC5851491, DOI: 10.5811/westjem.2017.9.35341.Peer-Reviewed Original ResearchConceptsTransient ischemic attackTotal hospital LOSHospital LOSEmergency departmentED LOSFinal diagnosisRecurrent transient ischemic attacksTertiary care academic centerED observation unitIntermediate-risk patientsHigh-risk patientsProportion of patientsMedian ED LOSInpatient admission ratesNeck CT angiographyBrain magnetic resonanceNeck MR angiographyStandardized clinical protocolUse of neuroimagingIschemic attackCohort studyTIA symptomsConsecutive patientsED lengthSix-month periodDiabetes 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
Recrudescence of Deficits After Stroke: Clinical and Imaging Phenotype, Triggers, and Risk Factors
Topcuoglu M, Saka E, Silverman S, Schwamm L, Singhal A. Recrudescence of Deficits After Stroke: Clinical and Imaging Phenotype, Triggers, and Risk Factors. JAMA Neurology 2017, 74: 1048-1055. PMID: 28783808, PMCID: PMC5710180, DOI: 10.1001/jamaneurol.2017.1668.Peer-Reviewed Original ResearchConceptsTransient ischemic attackRisk factorsIschemic attackChronic strokeMean ageDiagnostic criteriaPSR groupHealth Stroke Scale scoreIntravenous tissue plasminogen activatorMiddle cerebral artery territoryResearch Patient Data RepositoryCrossover cohort studyHypertensive brain hemorrhagePatients' mean ageStroke Scale scoreFocal neurologic deficitsSmall vessel diseaseCase-control studyPreliminary diagnostic criteriaTissue plasminogen activatorStroke-related deficitsMagnetic resonance imagingWhite matter tractsDiffusion-weighted imagingPatient data repositoryCurrent Practice Trends for Use of Early Venous Thromboembolism Prophylaxis After Intracerebral Hemorrhage
Cherian L, Smith E, Schwamm L, Fonarow G, Schulte P, Xian Y, Wu J, Prabhakaran S. Current Practice Trends for Use of Early Venous Thromboembolism Prophylaxis After Intracerebral Hemorrhage. Neurosurgery 2017, 82: 85-92. PMID: 28379461, DOI: 10.1093/neuros/nyx146.Peer-Reviewed Original ResearchConceptsHospital day 2Early chemoprophylaxisIntracerebral hemorrhageVTE prophylaxisDay 2Venous thromboembolismEarly Venous Thromboembolism ProphylaxisEarly VTE prophylaxisGuidelines-Stroke registryMechanical VTE prophylaxisPrior ischemic strokeCP useTransient ischemic attackVenous thromboembolism prophylaxisObservational cohort studyPeripheral artery diseaseMultivariable logistic regressionAcute care facilitiesComfort care measuresCurrent practice trendsIschemic attackProphylaxis statusThromboembolism prophylaxisMechanical prophylaxisCohort study
2015
An International Standard Set of Patient-Centered Outcome Measures After Stroke
Salinas J, Sprinkhuizen S, Ackerson T, Bernhardt J, Davie C, George M, Gething S, Kelly A, Lindsay P, Liu L, Martins S, Morgan L, Norrving B, Ribbers G, Silver F, Smith E, Williams L, Schwamm L. An International Standard Set of Patient-Centered Outcome Measures After Stroke. Stroke 2015, 47: 180-186. PMID: 26604251, PMCID: PMC4689178, DOI: 10.1161/strokeaha.115.010898.Peer-Reviewed Original ResearchConceptsPatient-reported outcomesOutcome measuresInternational standard setTransient ischemic attackHealth-related qualityCare-related factorsStroke Outcome MeasureSystemic risk factorsDifferent care settingsPreferred outcome measureRisk-adjustment variablesValue-based health careInternational expert panelIschemic attackAcute complicationsIschemic strokePatient demographicsStroke outcomeStroke RegisterIntracerebral hemorrhageStroke careStroke managementRisk factorsStroke typeCare settingsQuality of Care and Ischemic Stroke Risk After Hospitalization for Transient Ischemic Attack
O'Brien E, Zhao X, Fonarow G, Schulte P, Dai D, Smith E, Schwamm L, Bhatt D, Xian Y, Saver J, Reeves M, Peterson E, Hernandez A. Quality of Care and Ischemic Stroke Risk After Hospitalization for Transient Ischemic Attack. Circulation Cardiovascular Quality And Outcomes 2015, 8: s117-s124. PMID: 26515199, DOI: 10.1161/circoutcomes.115.002048.Peer-Reviewed Original ResearchConceptsTransient ischemic attackDefect-free careIschemic strokeIschemic stroke riskQuality of careIschemic attackStroke riskCare measuresRisk scoreOverall hospital admission rateRisk score quintilesYear post dischargeLow-risk patientsHospital admission ratesIschemic stroke admissionsPrevious myocardial infarctionAbsence of strokeMedicare inpatient claimsCox proportional hazardsModerate discriminative performanceTIA patientsCause mortalityCessation counselingStroke admissionsBaseline demographicsNovel Oral Anticoagulant Use Among Patients With Atrial Fibrillation Hospitalized With Ischemic Stroke or Transient Ischemic Attack
Patel P, Zhao X, Fonarow G, Lytle B, Smith E, Xian Y, Bhatt D, Peterson E, Schwamm L, Hernandez A. Novel Oral Anticoagulant Use Among Patients With Atrial Fibrillation Hospitalized With Ischemic Stroke or Transient Ischemic Attack. Circulation Cardiovascular Quality And Outcomes 2015, 8: 383-392. PMID: 26058721, PMCID: PMC4512906, DOI: 10.1161/circoutcomes.114.000907.Peer-Reviewed Original ResearchConceptsNovel oral anticoagulantsTransient ischemic attackAtrial fibrillation patientsIschemic attackIschemic strokeFibrillation patientsEligible patientsWarfarin therapyAtrial fibrillationNovel oral anticoagulant useCHA2DS2-VASc scoreRate of anticoagulationOral anticoagulant useLower stroke riskMultivariable logistic regressionAnticoagulation ratesGuidelines-StrokeNOAC useAnticoagulant useOral anticoagulantsStroke riskRisk factorsStudy populationPatterns of usePatients
2014
Guideline-Directed Low-Density Lipoprotein Management in High-Risk Patients With Ischemic Stroke
Saposnik G, Fonarow G, Pan W, Liang L, Hernandez A, Schwamm L, Smith E. Guideline-Directed Low-Density Lipoprotein Management in High-Risk Patients With Ischemic Stroke. Stroke 2014, 45: 3343-3351. PMID: 25300975, DOI: 10.1161/strokeaha.114.006736.Peer-Reviewed Original ResearchConceptsTransient ischemic attackCoronary artery diseaseHigh-risk patientsTIA/strokeIschemic attackIschemic strokeLDL targetsCardiovascular diseasePrevious stroke/transient ischemic attackStroke/transient ischemic attackConcomitant coronary artery diseasePreexistent coronary artery diseasePrevious TIA/strokePrior TIA/strokePrevious coronary artery diseaseMajor vascular risk factorsLow-density lipoprotein valuesGuidelines-Stroke registryAcute ischemic strokeManagement of dyslipidemiaVascular risk factorsCholesterol-lowering therapyLipoprotein managementRecurrent strokeStroke preventionGuidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack
Kernan WN, Ovbiagele B, Black HR, Bravata DM, Chimowitz MI, Ezekowitz MD, Fang MC, Fisher M, Furie KL, Heck DV, Johnston SC, Kasner SE, Kittner SJ, Mitchell PH, Rich MW, Richardson D, Schwamm LH, Wilson JA. Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack. Stroke 2014, 45: 2160-2236. PMID: 24788967, DOI: 10.1161/str.0000000000000024.Peer-Reviewed Original ResearchConceptsTransient ischemic attackEvidence-based recommendationsIschemic attackCerebral venous sinus thrombosisTimely evidence-based recommendationsAntiphospholipid antibody syndromeVenous sinus thrombosisPrevention of strokeAortic arch atherosclerosisSickle cell diseaseImplementation of guidelinesAntibody syndromeFuture strokeRecurrent strokeAnticoagulation therapyAntiplatelet therapyAntithrombotic therapySinus thrombosisIschemic strokeNoncardioembolic strokeSecondary preventionArterial dissectionHypercoagulable statePatent foramenIntracranial hemorrhage