2019
Resource utilisation among patients transferred for intracerebral haemorrhage
Zachrison K, Aaronson E, Mahmood S, Rosand J, Viswanathan A, Schwamm L, Goldstein J. Resource utilisation among patients transferred for intracerebral haemorrhage. Stroke And Vascular Neurology 2019, 4: 223. PMID: 32030206, PMCID: PMC6979870, DOI: 10.1136/svn-2019-000255.Peer-Reviewed Original ResearchMeSH KeywordsAcademic Medical CentersAge FactorsAgedAged, 80 and overCerebral HemorrhageCritical CareFemaleGlasgow Coma ScaleHumansIntensive Care UnitsMaleMiddle AgedNeurosurgical ProceduresPatient AdmissionPatient TransferProspective StudiesRegistriesRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeConceptsGlasgow Coma ScoreIntracerebral hemorrhageSurgical interventionICH scoreAcademic hospitalBaseline Glasgow Coma ScoreIntensive care unit admissionCare unit admissionSingle academic hospitalPrimary intracerebral hemorrhageUrban academic hospitalLess frequent useCollected registryICU stayUnit admissionComa ScoreConsecutive patientsIntraventricular hemorrhagePrimary outcomePrimary patientsPatientsHospitalLogistic regressionHemorrhageResource utilisationRelation 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
Quality 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 characteristicsRates, 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 outcomesComparison of Acute Ischemic Stroke Care and Outcomes Between Comprehensive Stroke Centers and Primary Stroke Centers in the United States
Man S, Zhao X, Uchino K, Hussain M, Smith E, Bhatt D, Xian Y, Schwamm L, Shah S, Khan Y, Fonarow G. Comparison of Acute Ischemic Stroke Care and Outcomes Between Comprehensive Stroke Centers and Primary Stroke Centers in the United States. Circulation Cardiovascular Quality And Outcomes 2018, 11: e004512. PMID: 29794035, PMCID: PMC5978771, DOI: 10.1161/circoutcomes.117.004512.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBrain IschemiaCertificationComprehensive Health CareDelivery of Health Care, IntegratedEmergency Service, HospitalEndovascular ProceduresFemaleHospital MortalityHospitalsHumansMaleMiddle AgedOutcome and Process Assessment, Health CarePatient AdmissionPatient TransferQuality ImprovementQuality Indicators, Health CareRecovery of FunctionRegistriesRisk AssessmentRisk FactorsStrokeThrombolytic TherapyTime FactorsTime-to-TreatmentTreatment OutcomeUnited StatesConceptsPrimary stroke centerEmergency department admissionsStroke center certificationAcute ischemic strokeIschemic stroke careStroke centersStroke careDepartment admissionsHospital mortalityHospital outcomesIntravenous tPAIschemic strokeCenter certificationTPA timeComprehensive Stroke Center (CSC) certificationAcute ischemic stroke careMultivariable logistic regression modelAcute reperfusion therapyAcute stroke triageBrain Attack CoalitionDefect-free careComprehensive stroke centerOverall care qualityLogistic regression modelsGuidelines-StrokeAbsence of July Phenomenon in Acute Ischemic Stroke Care Quality and Outcomes
Gonzalez‐Castellon M, Ju C, Xian Y, Hernandez A, Fonarow G, Schwamm L, Smith E, Bhatt D, Reeves M, Willey J. Absence of July Phenomenon in Acute Ischemic Stroke Care Quality and Outcomes. Journal Of The American Heart Association 2018, 7: e007685. PMID: 29386207, PMCID: PMC5850252, DOI: 10.1161/jaha.117.007685.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBrain IschemiaClinical CompetenceFemaleHealth StatusHospitals, TeachingHumansInternship and ResidencyMaleMiddle AgedOutcome and Process Assessment, Health CarePatient AdmissionPatient DischargePersonnel Staffing and SchedulingQuality Indicators, Health CareRegistriesStrokeTime FactorsTime-to-TreatmentTreatment OutcomeUnited StatesConceptsGuidelines-Stroke programProportion of patientsAcute ischemic strokeIschemic strokeJuly phenomenonHospital outcomesAcute ischemic stroke care qualityMultivariable logistic regression modelCare qualityDefect-free careStroke care qualityStroke performance measuresSymptomatic intracranial hemorrhageHours of admissionLower care qualityLogistic regression modelsNeedle timeIntracranial hemorrhageMultivariable analysisAdverse outcomesNonteaching hospitalsTomography timePatientsClinical metricsHospital
2017
Immediate Vascular Imaging Needed for Efficient Triage of Patients With Acute Ischemic Stroke Initially Admitted to Nonthrombectomy Centers
Boulouis G, Siddiqui K, Lauer A, Charidimou A, Regenhardt R, Viswanathan A, Leslie-Mazwi T, Rost N, Schwamm L. Immediate Vascular Imaging Needed for Efficient Triage of Patients With Acute Ischemic Stroke Initially Admitted to Nonthrombectomy Centers. Stroke 2017, 48: 2297-2300. PMID: 28687641, DOI: 10.1161/strokeaha.117.017607.Peer-Reviewed Original ResearchConceptsThrombectomy-capable stroke centersEndovascular thrombectomyVascular imagingCurrent guidelinesAlberta Stroke Program Early CT ScoreUnnecessary transfersHealth Stroke ScaleAcute ischemic strokeMain outcome variablesBaseline vascularStroke ScaleIschemic strokeStroke centersCT scoreFutile transfersPatientsEfficient triageHospitalYielded sensitivityOutcome variablesOptimal selection criteriaNational InstituteStrokeImagingOcclusion level
2014
Development and Initial Testing of the Stroke Rapid-Treatment Readiness Tool
Olson D, Cox M, Constable M, Britz G, Lin C, Zimmer L, Fonarow G, Schwamm L, Peterson E. Development and Initial Testing of the Stroke Rapid-Treatment Readiness Tool. Journal Of Neuroscience Nursing 2014, 46: 267-273. PMID: 25099063, PMCID: PMC4165480, DOI: 10.1097/jnn.0000000000000082.Peer-Reviewed Original ResearchConceptsIntravenous tissue plasminogen activatorTissue plasminogen activatorPlasminogen activatorQuality Improvement ProgramGuidelines-StrokeEligible patientsHospital arrivalIschemic strokeNeedle timeHealth systemU.S. hospitalsHospitalReadiness ToolInitial testingLikert scale surveyPatientsActivatorImprovement programsStrokeAdministration
2013
Impact on Clinical and Cost Outcomes of a Centralized Approach to Acute Stroke Care in London: A Comparative Effectiveness Before and After Model
Hunter R, Davie C, Rudd A, Thompson A, Walker H, Thomson N, Mountford J, Schwamm L, Deanfield J, Thompson K, Dewan B, Mistry M, Quoraishi S, Morris S. Impact on Clinical and Cost Outcomes of a Centralized Approach to Acute Stroke Care in London: A Comparative Effectiveness Before and After Model. PLOS ONE 2013, 8: e70420. PMID: 23936427, PMCID: PMC3731285, DOI: 10.1371/journal.pone.0070420.Peer-Reviewed Original ResearchMeSH KeywordsAgedCost-Benefit AnalysisFemaleHumansKaplan-Meier EstimateLondonMaleModels, StatisticalPatient AdmissionRegistriesStrokeTreatment OutcomeConceptsAcute stroke careHyper-acute stroke unitLength of stayStroke careStroke patientsReduced hospital lengthAcute stroke patientsNational time trendsDecision analytic modelHospital lengthPatient characteristicsStroke RegisterStroke unitClinical outcomesSpecialist careLocal hospitalPatientsSurvival rateComparative effectivenessCost outcomesSurvival analysisStayTotal cost savingsMortalityCare
2007
Serum lipid profile on admission for ischemic stroke
Smith E, Abdullah A, Amirfarzan H, Schwamm L. Serum lipid profile on admission for ischemic stroke. Neurology 2007, 68: 660-665. PMID: 17325272, DOI: 10.1212/01.wnl.0000255941.03761.dc.Peer-Reviewed Original ResearchConceptsLipid-lowering agentsLow-density lipoproteinStroke/TIALDL goalLDL targetsNational Cholesterol Education Program Adult Treatment Panel guidelinesAdult Treatment Panel guidelinesLow-density lipoprotein levelsIschemic stroke/TIACharacteristics of patientsSerum lipid profileATPIII guidelinesCardiovascular eventsIschemic strokeLipoprotein levelsLDL levelsLipid profileMultivariable modelPanel guidelinesLipid measurementsNational guidelinesTherapeutic targetGreater riskPatientsCalendar time