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
2023
Insurance-Based Disparities in Stroke Center Access in California: A Network Science Approach
Zachrison K, Hsia R, Schwamm L, Yan Z, Samuels-Kalow M, Reeves M, Camargo C, Onnela J. Insurance-Based Disparities in Stroke Center Access in California: A Network Science Approach. Circulation Cardiovascular Quality And Outcomes 2023, 16: e009868. PMID: 37746725, PMCID: PMC10592016, DOI: 10.1161/circoutcomes.122.009868.Peer-Reviewed Original ResearchConceptsInsurance-based disparitiesStroke centersEmergency departmentHospital clustersInitial emergency departmentIschemic stroke admissionsHospital emergency departmentClusters of hospitalsLogistic regression modelsStroke admissionsUninsured patientsPatient insuranceLower oddsPatientsLess strokeCenter accessOddsCenter transferHospitalLikelihood of transferInsurance groupsRegression modelsLower proportionDepartmentAssociation
2019
Hospital distance, socioeconomic status, and timely treatment of ischemic stroke.
Ader J, Wu J, Fonarow GC, Smith EE, Shah S, Xian Y, Bhatt DL, Schwamm LH, Reeves MJ, Matsouaka RA, Sheth KN. Hospital distance, socioeconomic status, and timely treatment of ischemic stroke. Neurology 2019, 93: e747-e757. PMID: 31320472, PMCID: PMC6711658, DOI: 10.1212/wnl.0000000000007963.Peer-Reviewed Original ResearchConceptsTPA administrationHome zip codeSocioeconomic statusHospital mortalityTime quartilesLower oddsHierarchical multivariable logistic regression modelsTissue plasminogen activator administrationPatient's home zip codeMultivariable logistic regression modelZip code median household incomeGuidelines-Stroke registryPatients' socioeconomic statusRetrospective observational studyLow socioeconomic statusEmergency medical servicesLogistic regression modelsLowest SES quintileHigher socioeconomic statusShorter OTTIschemic strokeSecondary outcomesPatient agePrimary outcomeObservational study
2017
Professional Medical Interpreters Influence the Quality of Acute Ischemic Stroke Care for Patients Who Speak Languages Other than English
Erfe B, Siddiqui K, Schwamm L, Kirwan C, Nunes A, Mejia N. Professional Medical Interpreters Influence the Quality of Acute Ischemic Stroke Care for Patients Who Speak Languages Other than English. Journal Of The American Heart Association 2017, 6: e006175. PMID: 28935679, PMCID: PMC5634277, DOI: 10.1161/jaha.117.006175.Peer-Reviewed Original ResearchConceptsProfessional medical interpretersMedical interpretersAcute ischemic stroke careIschemic stroke careAcute ischemic stroke patientsIschemic stroke patientsStroke carePMI servicesCommon languageEnglishLanguageStroke patientsInterpretersGuidelines-Stroke programAmerican Heart AssociationAppropriate health careLogistic regression modelsQuality patient careHospital stayMultivariable analysisPatient receiptHeart AssociationLower oddsPatientsMedical careAssociation of Preceding Antithrombotic Treatment With Acute Ischemic Stroke Severity and In-Hospital Outcomes Among Patients With Atrial Fibrillation
Xian Y, O’Brien E, Liang L, Xu H, Schwamm L, Fonarow G, Bhatt D, Smith E, Olson D, Maisch L, Hannah D, Lindholm B, Lytle B, Pencina M, Hernandez A, Peterson E. Association of Preceding Antithrombotic Treatment With Acute Ischemic Stroke Severity and In-Hospital Outcomes Among Patients With Atrial Fibrillation. JAMA 2017, 317: 1057-1067. PMID: 28291892, DOI: 10.1001/jama.2017.1371.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeHistory of AFAntithrombotic therapyAntiplatelet therapyAntithrombotic treatmentAtrial fibrillationHospital mortalityTherapeutic warfarinTherapeutic anticoagulationSevere strokeIschemic strokeStroke severityLower oddsSubtherapeutic warfarinUnadjusted ratesAcute ischemic stroke severityGuidelines-Stroke programHealth Stroke ScaleIn-Hospital OutcomesHigh-risk patientsPrevalence of patientsRetrospective observational studyTime of strokeIschemic stroke severityHospital outcomesDelays in Door-to-Needle Times and Their Impact on Treatment Time and Outcomes in Get With The Guidelines-Stroke
Kamal N, Sheng S, Xian Y, Matsouaka R, Hill M, Bhatt D, Saver J, Reeves M, Fonarow G, Schwamm L, Smith E. Delays in Door-to-Needle Times and Their Impact on Treatment Time and Outcomes in Get With The Guidelines-Stroke. Stroke 2017, 48: 946-954. PMID: 28228574, DOI: 10.1161/strokeaha.116.015712.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBrain IschemiaDelivery of Health CareFemaleFibrinolytic AgentsGuideline AdherenceHospital MortalityHumansIntracranial HemorrhagesMaleMiddle AgedOutcome and Process Assessment, Health CareOutcome Assessment, Health CareStrokeThrombolytic TherapyTime FactorsTissue Plasminogen ActivatorConceptsNeedle timeGuidelines-StrokeAcute ischemic stroke patientsSymptomatic intracranial hemorrhageIschemic stroke patientsQuality Improvement ProgramTissue-type plasminogen activatorAcute comorbiditiesHospital mortalityInpatient strokeIntravenous alteplaseLonger doorIndependent ambulationDelay diagnosisIntracranial hemorrhageStroke patientsHospital characteristicsPatient outcomesHigher oddsLower oddsPatientsPlasminogen activatorStroke recognitionHospitalDiagnosis
2014
Racial/Ethnic Differences in Process of Care and Outcomes Among Patients Hospitalized With Intracerebral Hemorrhage
Xian Y, Holloway R, Smith E, Schwamm L, Reeves M, Bhatt D, Schulte P, Cox M, Olson D, Hernandez A, Lytle B, Anstrom K, Fonarow G, Peterson E. Racial/Ethnic Differences in Process of Care and Outcomes Among Patients Hospitalized With Intracerebral Hemorrhage. Stroke 2014, 45: 3243-3250. PMID: 25213344, DOI: 10.1161/strokeaha.114.005620.Peer-Reviewed Original ResearchConceptsWhite patientsAsian patientsRace/ethnicityCessation counselingLower oddsDeep venous thrombosis prophylaxisGuidelines-Stroke hospitalsStroke performance measuresVenous thrombosis prophylaxisHospital-level characteristicsMultivariable logistic regressionProcess of careEthnic differencesHospital mortalityThrombosis prophylaxisCause mortalityHospital outcomesSevere strokeDysphagia screeningBlack patientsIntracerebral hemorrhageMedian lengthHigher oddsStroke educationComfort measuresSecondary Prevention after Ischemic Stroke or Transient Ischemic Attack
Bangalore S, Schwamm L, Smith E, Singh I, Liang L, Fonarow G, Bhatt D, Committee and Investigators G. Secondary Prevention after Ischemic Stroke or Transient Ischemic Attack. The American Journal Of Medicine 2014, 127: 728-738. PMID: 24681258, DOI: 10.1016/j.amjmed.2014.03.011.Peer-Reviewed Original ResearchConceptsTransient ischemic attackIschemic attackIschemic strokeSecondary prevention measuresEvidence-based therapiesSecondary preventionRecurrent strokeEvidence-based secondary preventionInitial transient ischemic attackGuidelines-Stroke registryIntensive statin therapyLipid-lowering medicationsLDL cholesterol measurementsWeight loss recommendationsPrevention measuresCessation counselingStatin therapyAtrial fibrillationHospital characteristicsHospital adherenceObservational studyStroke educationLower oddsPatientsCholesterol measurement
2013
Relationship of Race/Ethnicity With Door‐to‐Balloon Time and Mortality in Patients Undergoing Primary Percutaneous Coronary Intervention for ST‐Elevation Myocardial Infarction: Findings From Get With the Guidelines–Coronary Artery Disease
Cavender M, Rassi A, Fonarow G, Cannon C, Peacock W, Laskey W, Hernandez A, Peterson E, Cox M, Grau‐Sepulveda M, Schwamm L, Bhatt D. Relationship of Race/Ethnicity With Door‐to‐Balloon Time and Mortality in Patients Undergoing Primary Percutaneous Coronary Intervention for ST‐Elevation Myocardial Infarction: Findings From Get With the Guidelines–Coronary Artery Disease. Clinical Cardiology 2013, 36: 749-756. PMID: 24085713, PMCID: PMC6649362, DOI: 10.1002/clc.22213.Peer-Reviewed Original ResearchMeSH KeywordsAgedBlack or African AmericanChi-Square DistributionFemaleGuideline AdherenceHealth Services AccessibilityHealthcare DisparitiesHispanic or LatinoHospital MortalityHumansLinear ModelsLogistic ModelsMaleMiddle AgedMultivariate AnalysisMyocardial InfarctionOdds RatioPercutaneous Coronary InterventionPractice Guidelines as TopicProspective StudiesRegistriesRisk FactorsTime FactorsTime-to-TreatmentTreatment OutcomeUnited StatesWhite PeopleConceptsPrimary percutaneous coronary interventionPrimary PCIST-elevation myocardial infarctionDTB timeMedian DTB timeRace/ethnicityPercutaneous coronary interventionCoronary interventionArtery diseaseBalloon timeMyocardial infarctionGuidelines-Coronary Artery DiseaseProportion of patientsAfrican American raceAfrican AmericansAfrican American femalesDifferent races/ethnicitiesHospital mortalityD2B timeHispanic patientsHispanic ethnicityLower oddsAmerican racePatientsCrude differencesRacial and Ethnic Differences in Outcomes in Older Patients With Acute Ischemic Stroke
Qian F, Fonarow G, Smith E, Xian Y, Pan W, Hannan E, Shaw B, Glance L, Peterson E, Eapen Z, Hernandez A, Schwamm L, Bhatt D. Racial and Ethnic Differences in Outcomes in Older Patients With Acute Ischemic Stroke. Circulation Cardiovascular Quality And Outcomes 2013, 6: 284-292. PMID: 23680966, DOI: 10.1161/circoutcomes.113.000211.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overBlack or African AmericanBrain IschemiaEthnicityFemaleHealth Status DisparitiesHealthcare DisparitiesHispanic or LatinoHumansLogistic ModelsMaleMedicareMultivariate AnalysisOdds RatioPatient ReadmissionRacial GroupsRegistriesRisk FactorsSeverity of Illness IndexStrokeTime FactorsTreatment OutcomeUnited StatesWhite PeopleConceptsAcute ischemic strokeLong-term outcomesRace/ethnicityCause rehospitalizationOlder patientsIschemic strokeUnadjusted mortalityHispanic patientsGuidelines-Stroke programGuidelines-Stroke registryHealth Stroke ScaleOlder Medicare beneficiariesAmerican Heart AssociationAsian American patientsYears of ageStroke ScaleStroke severityHigher median scoresAsian patientsHeart AssociationHospital characteristicsAmerican patientsUS CentersPrognostic variablesLower odds
2012
Regional Variation in Recommended Treatments for Ischemic Stroke and TIA
Allen NB, Kaltenbach L, Goldstein LB, Olson DM, Smith EE, Peterson ED, Schwamm L, Lichtman JH. Regional Variation in Recommended Treatments for Ischemic Stroke and TIA. Stroke 2012, 43: 1858-1864. PMID: 22588262, DOI: 10.1161/strokeaha.112.652305.Peer-Reviewed Original ResearchConceptsDefect-free careLipid-lowering medicationsTissue-type plasminogen activatorLower oddsIschemic strokeIntravenous tissue-type plasminogen activatorSecondary stroke prevention treatmentDeep vein thrombosis prophylaxisTissue-type plasminogen activator administrationNational quality improvement programPlasminogen activatorGuideline-recommended treatmentGuidelines-Stroke hospitalsTransient ischemic attackQuarter of patientsStroke prevention treatmentBetter patient outcomesWeight loss educationQuality Improvement ProgramEligible patientsIschemic attackThrombosis prophylaxisPatient demographicsStroke treatmentMedical history