2022
Association Between Endovascular Therapy Time to Treatment and Outcomes in Patients With Basilar Artery Occlusion
Joundi R, Sun J, Xian Y, Alhanti B, Nogueira R, Bhatt D, Fonarow G, Saver J, Schwamm L, Smith E. Association Between Endovascular Therapy Time to Treatment and Outcomes in Patients With Basilar Artery Occlusion. Circulation 2022, 145: 896-905. PMID: 35050693, DOI: 10.1161/circulationaha.121.056554.Peer-Reviewed Original ResearchConceptsBasilar artery occlusionSymptomatic intracranial hemorrhageEndovascular therapySymptom onsetEVT timesHospital mortalityArtery occlusionMedian onsetIntracranial hemorrhageBetter outcomesHealth Stroke Scale scoreIndividual-level patient dataMedian National InstitutesStroke Scale scoreHospital-level factorsProportion of patientsLogistic regression modelsSubstantial reperfusionAnterior circulationPrimary outcomeUS registryMean ageDevastating conditionImproved outcomesTherapy time
2021
Reperfusion Treatment and Stroke Outcomes in Hospitals With Telestroke Capacity
Wilcock A, Schwamm L, Zubizarreta J, Zachrison K, Uscher-Pines L, Richard J, Mehrotra A. Reperfusion Treatment and Stroke Outcomes in Hospitals With Telestroke Capacity. JAMA Neurology 2021, 78: 527-535. PMID: 33646272, PMCID: PMC7922240, DOI: 10.1001/jamaneurol.2021.0023.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeReperfusion treatmentIschemic strokeShort-term acute carePatients 85 yearsLow-volume hospitalsYear of admissionHospital emergency departmentTraditional Medicare beneficiariesClinical characteristicsCritical access hospitalsStroke outcomeAcute careControl hospitalsEmergency departmentMean ageFunctional statusPrimary diagnosisStroke expertiseHospital characteristicsMAIN OUTCOMEMedicare beneficiariesPatientsHospitalCare patterns
2020
Trends 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 study
2018
Participation in Get With the Guidelines–Stroke and Its Association With Quality of Care for Stroke
Howard G, Schwamm LH, Donnelly JP, Howard VJ, Jasne A, Smith EE, Rhodes JD, Kissela BM, Fonarow GC, Kleindorfer DO, Albright KC. Participation in Get With the Guidelines–Stroke and Its Association With Quality of Care for Stroke. JAMA Neurology 2018, 75: 1331-1337. PMID: 30083763, PMCID: PMC6248106, DOI: 10.1001/jamaneurol.2018.2101.Peer-Reviewed Original ResearchConceptsTissue plasminogen activatorIschemic strokeQuality of careGuidelines-StrokeGWTG-StrokeMean ageNonparticipating hospitalsCare measuresRisk factorsPopulation-based cohort studyPlasminogen activatorLipid profile assessmentParticipants 45 yearsStroke risk factorsQuality Improvement ProgramEvidence-based interventionsExercise counselingNeurologist evaluationAntithrombotic therapyCohort studyAntithrombotic useStroke careMAIN OUTCOMELipid evaluationHospitalQuality of Care and Outcomes for Patients With Stroke in the United States Admitted During the International Stroke Conference
Messé S, Mullen M, Cox M, Fonarow G, Smith E, Saver J, Reeves M, Bhatt D, Matsouaka R, Schwamm L. Quality of Care and Outcomes for Patients With Stroke in the United States Admitted During the International Stroke Conference. Journal Of The American Heart Association 2018, 7: e009842. PMID: 30376750, PMCID: PMC6404171, DOI: 10.1161/jaha.118.009842.Peer-Reviewed Original ResearchConceptsIntravenous tissue plasminogen activatorTissue plasminogen activatorAcute ischemic strokeInternational Stroke ConferencePlasminogen activatorWorse outcomesGuideline-adherent careGuidelines-Stroke hospitalsRetrospective cohort studyHours of onsetMinutes of arrivalExperience worse outcomesQuality of careSame quality careAverage weekly numberGuidelines-StrokeAcute strokeBackground PatientsCohort studyConclusions PatientsIschemic strokeClinical outcomesMean ageStroke cliniciansHospital characteristicsFactors associated with 1-year mortality after discharge for acute stroke: what matters?
Magdon-Ismail Z, Ledneva T, Sun M, Schwamm L, Sherman B, Qian F, Bettger J, Xian Y, Stein J. Factors associated with 1-year mortality after discharge for acute stroke: what matters? Topics In Stroke Rehabilitation 2018, 25: 576-583. PMID: 30281414, DOI: 10.1080/10749357.2018.1499303.Peer-Reviewed Original ResearchConceptsInpatient rehabilitation facilitySkilled nursing facilitiesAcute strokeDischarge destinationHealth Stroke ScaleHigher National InstitutesRetrospective cohort studyLong-term outcomesLong-term survivalCause mortalityStroke ScaleCohort studyIschemic strokeAmbulation statusIntracerebral hemorrhageMean ageMultivariate regression modelClinical dataNursing facilitiesRehabilitation facilityTherapeutic targetOlder ageMortalityStrokeNational InstituteIsolated Upper Limb Weakness From Ischemic Stroke: Mechanisms and Outcome
Topcuoglu M, Rocha E, Siddiqui A, Mills B, Silva G, Schwamm L, Lamuraglia G, Singhal A. Isolated Upper Limb Weakness From Ischemic Stroke: Mechanisms and Outcome. Journal Of Stroke And Cerebrovascular Diseases 2018, 27: 2712-2719. PMID: 30033098, DOI: 10.1016/j.jstrokecerebrovasdis.2018.05.050.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBrain IschemiaCarotid StenosisCerebral AngiographyComputed Tomography AngiographyDiffusion Magnetic Resonance ImagingDisability EvaluationEmbolismFemaleHeart DiseasesHumansMagnetic Resonance AngiographyMaleMiddle AgedMotor ActivityMotor CortexMuscle StrengthMuscle WeaknessMuscle, SkeletalPlaque, AtheroscleroticPrognosisRecovery of FunctionRetrospective StudiesRisk FactorsRupture, SpontaneousStrokeUpper ExtremityConceptsCarotid artery stenosisArtery stenosisCarotid stenosisSubcortical white matter infarctsClinical imaging featuresUpper extremity weaknessDiffusion-weighted magnetic resonance imagingUpper limb weaknessRecurrent stroke riskWhite matter infarctsMagnetic resonance imagingCardioembolic mechanismRecurrent strokeBrainstem infarctsExtremity weaknessMultiple infarctsIschemic strokeLimb weaknessStroke riskMotor stripStroke evaluationMean agePlaque ulcerationStroke mechanismInfarcts
2017
Ischemic Stroke Profile, Risk Factors, and Outcomes in India
Sylaja P, Pandian J, Kaul S, Srivastava M, Khurana D, Schwamm L, Kesav P, Arora D, Pannu A, Thankachan T, Singhal A. Ischemic Stroke Profile, Risk Factors, and Outcomes in India. Stroke 2017, 49: 219-222. PMID: 29167386, PMCID: PMC5742046, DOI: 10.1161/strokeaha.117.018700.Peer-Reviewed Original ResearchConceptsAdmission National InstitutesHealth Stroke ScaleStroke ScaleIschemic strokeDiabetes mellitusRisk factorsHealth Stroke Scale scoreLower admission National InstitutesMedian admission National InstitutesNational InstituteRankin Scale score 0Stroke etiologic subtypesIntra-arterial thrombolysisStroke Scale scoreAcademic tertiary hospitalCommon risk factorsMagnetic resonance imagingHospital mortalityEtiologic subtypesStroke careStroke ProjectTertiary hospitalAtrial fibrillationStroke guidelinesMean ageIs Risk-Standardized In-Hospital Stroke Mortality an Adequate Proxy for Risk-Standardized 30-Day Stroke Mortality Data?
Reeves M, Fonarow G, Xu H, Matsouaka R, Xian Y, Saver J, Schwamm L, Smith E. Is Risk-Standardized In-Hospital Stroke Mortality an Adequate Proxy for Risk-Standardized 30-Day Stroke Mortality Data? Circulation Cardiovascular Quality And Outcomes 2017, 10: e003748. PMID: 29021333, DOI: 10.1161/circoutcomes.117.003748.Peer-Reviewed Original ResearchMeSH KeywordsAdministrative Claims, HealthcareAgedAged, 80 and overBrain IschemiaDatabases, FactualFemaleGuideline AdherenceHospice CareHospital MortalityHospitalsHumansMaleMedicarePatient DischargePractice Guidelines as TopicQuality ImprovementQuality Indicators, Health CareRisk AssessmentRisk FactorsStrokeTime FactorsUnited StatesConceptsRisk-standardized mortality ratesHospital mortalityOutlier hospitalsAcute ischemic stroke casesHospital risk-standardized mortality ratesMortality dataGWTG-Stroke hospitalsHospital stroke mortalityIschemic stroke patientsProportion of hospitalsIschemic stroke casesRisk score modelStroke mortality dataChance-corrected agreementComposite outcomeStroke patientsMean ageStroke casesStroke mortalityMedicare filesHospital levelMortality rateLower mortalityHospitalMortalityRecrudescence 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 repository
2016
Patient-reported financial barriers to adherence to treatment in neurology
Moura L, Schwamm E, Moura V, Seitz M, Hoch D, Hsu J, Schwamm L. Patient-reported financial barriers to adherence to treatment in neurology. ClinicoEconomics And Outcomes Research 2016, Volume 8: 685-694. PMID: 27895506, PMCID: PMC5117903, DOI: 10.2147/ceor.s119971.Peer-Reviewed Original ResearchMedication adherenceFinancial barriersPatient-reported failuresEffective medical therapyRoutine outpatient carePatient-reported dataCross-sectional surveyNeurology appointmentPatient characteristicsMedical therapyNeurology clinicMean agePrescription medicationsOutpatient careNeurological conditionsClinical informationNeurological diseasesNeurological disordersPatientsDemographic characteristicsAdherenceNonadherenceTherapyPreferred languageMedications
2015
Increased Risk of Cerebrovascular Disease Among Patients With Neurofibromatosis Type 1
Terry A, Jordan J, Schwamm L, Plotkin S. Increased Risk of Cerebrovascular Disease Among Patients With Neurofibromatosis Type 1. Stroke 2015, 47: 60-65. PMID: 26645253, DOI: 10.1161/strokeaha.115.011406.Peer-Reviewed Original ResearchConceptsNeurofibromatosis type 1Ischemic strokeIntracerebral hemorrhageGeneral populationCases of NF1US Nationwide Inpatient SampleType 1Hemorrhagic stroke typesNew neurological symptomsStroke risk factorsRisk of strokeOdds of strokeTime of strokeNationwide Inpatient SampleMultivariable logistic regressionCase-control studyType of strokeYounger mean ageAdult patientsPediatric patientsHemorrhagic strokeNeurological symptomsCerebrovascular diseaseMean ageInpatient Sample
2013
A Trial of Imaging Selection and Endovascular Treatment for Ischemic Stroke
Kidwell C, Jahan R, Gornbein J, Alger J, Nenov V, Ajani Z, Feng L, Meyer B, Olson S, Schwamm L, Yoo A, Marshall R, Meyers P, Yavagal D, Wintermark M, Guzy J, Starkman S, Saver J. A Trial of Imaging Selection and Endovascular Treatment for Ischemic Stroke. New England Journal Of Medicine 2013, 368: 914-923. PMID: 23394476, PMCID: PMC3690785, DOI: 10.1056/nejmoa1212793.Peer-Reviewed Original ResearchConceptsFavorable penumbral patternAcute ischemic strokeStandard carePenumbral patternIschemic strokeRankin ScaleNinety-day mortalitySymptomatic intracranial hemorrhageAnterior circulation strokeModified Rankin ScaleMagnetic resonance imagingEligible patientsEmbolectomy groupMechanical embolectomyEndovascular thrombectomyEndovascular therapySuch patientsClinical outcomesEndovascular treatmentIntracranial hemorrhageMean ageImaging selectionImaging patternsEmbolectomyPatients
2012
Relationship of National Institutes of Health Stroke Scale to 30‐Day Mortality in Medicare Beneficiaries With Acute Ischemic Stroke
Fonarow G, Saver J, Smith E, Broderick J, Kleindorfer D, Sacco R, Pan W, Olson D, Hernandez A, Peterson E, Schwamm L. Relationship of National Institutes of Health Stroke Scale to 30‐Day Mortality in Medicare Beneficiaries With Acute Ischemic Stroke. Journal Of The American Heart Association 2012, 1: 42-50. PMID: 23130117, PMCID: PMC3487316, DOI: 10.1161/jaha.111.000034.Peer-Reviewed Original ResearchAcute ischemic strokeHealth Stroke ScaleIschemic strokeMedicare beneficiariesNIHSS scoreStroke ScaleStroke severityMortality riskMortality rateGuidelines-Stroke hospitalsMedian NIHSS scoreSubstantial prognostic informationInitial stroke severityDiscrimination of riskService Medicare beneficiariesNational InstituteContinuous variablesMean ageC-statisticPrognostic informationRisk discriminationNIHSSClinical informationGraded relationStroke
2010
Hospital-Level Variation in Mortality and Rehospitalization for Medicare Beneficiaries With Acute Ischemic Stroke
Fonarow G, Smith E, Reeves M, Pan W, Olson D, Hernandez A, Peterson E, Schwamm L. Hospital-Level Variation in Mortality and Rehospitalization for Medicare Beneficiaries With Acute Ischemic Stroke. Stroke 2010, 42: 159-166. PMID: 21164109, DOI: 10.1161/strokeaha.110.601831.Peer-Reviewed Original ResearchConceptsIschemic strokeMedicare beneficiariesReadmission ratesPrimary stroke center designationGuidelines-Stroke hospitalsHospital-level outcomesStroke center designationAcute ischemic strokeCause readmission rateIschemic stroke mortalityHospital-level variationCause of deathRisk-adjusted outcomesHospital-level performanceRisk-adjusted ratesHospital dischargeRehospitalization ratesUnadjusted mortalityHospital admissionMean ageCenter designationStroke mortalityFavorable outcomeAcademic hospitalOutcome dataPatterns and Predictors of Discharge Statin Prescription Among Hospitalized Patients With Intracerebral Hemorrhage
Ovbiagele B, Schwamm L, Smith E, Hernandez A, Olson D, Pan W, Fonarow G, Saver J. Patterns and Predictors of Discharge Statin Prescription Among Hospitalized Patients With Intracerebral Hemorrhage. Stroke 2010, 41: 2271-2277. PMID: 20724709, DOI: 10.1161/strokeaha.110.593228.Peer-Reviewed Original ResearchConceptsDischarge statin prescriptionStatin prescriptionIntracerebral hemorrhageStatin useStatin treatmentPrior stroke/transient ischemic attackStroke/transient ischemic attackCholesterol Levels (SPARCL) trialStatin treatment armsLogistic multivariable regression modelsTransient ischemic attackHemorrhagic stroke riskHigher future riskMultivariable regression modelsGuidelines-StrokeIschemic attackEligible patientsStroke preventionIschemic eventsStroke riskHospitalized patientsHemorrhagic strokeTreatment armsMean ageFemale sexCharacteristics, Performance Measures, and In-Hospital Outcomes of the First One Million Stroke and Transient Ischemic Attack Admissions in Get With The Guidelines-Stroke
Fonarow G, Reeves M, Smith E, Saver J, Zhao X, Olson D, Hernandez A, Peterson E, Schwamm L. Characteristics, Performance Measures, and In-Hospital Outcomes of the First One Million Stroke and Transient Ischemic Attack Admissions in Get With The Guidelines-Stroke. Circulation Cardiovascular Quality And Outcomes 2010, 3: 291-302. PMID: 20177051, DOI: 10.1161/circoutcomes.109.921858.Peer-Reviewed Original ResearchConceptsHospital mortality rateIntracerebral hemorrhageQuality of careIschemic strokeSubarachnoid hemorrhageMortality rateTransient ischemic attack admissionsTransient ischemic attack patientsIn-Hospital OutcomesAcute ischemic strokeIschemic stroke patientsAdjusted odds ratioLength of stayQuality improvement effortsGuidelines-StrokeGWTG-StrokeTIA admissionsTIA careTIA patientsHospital outcomesAcute strokeStroke patientsMean ageAttack patientsNational surveillanceAge-Related Differences in Characteristics, Performance Measures, Treatment Trends, and Outcomes in Patients With Ischemic Stroke
Fonarow G, Reeves M, Zhao X, Olson D, Smith E, Saver J, Schwamm L. Age-Related Differences in Characteristics, Performance Measures, Treatment Trends, and Outcomes in Patients With Ischemic Stroke. Circulation 2010, 121: 879-891. PMID: 20142445, DOI: 10.1161/circulationaha.109.892497.Peer-Reviewed Original ResearchConceptsIschemic stroke patientsOlder patientsIschemic strokeAge-related differencesAge groupsClinical characteristicsStroke patientsTreatment gapGuideline-recommended therapiesGuidelines-Stroke programWorse poststroke outcomesEarly clinical outcomesAcute ischemic strokeLarge contemporary cohortIschemic stroke admissionsHospital mortalityHospital outcomesStroke admissionsYounger patientsClinical outcomesContemporary cohortRecent smokersAtrial fibrillationMean agePoststroke outcomes