2024
Mobile Stroke Unit Management in Patients With Acute Ischemic Stroke Eligible for Intravenous Thrombolysis
Mac Grory B, Sun J, Alhanti B, Lusk J, Li F, Adeoye O, Furie K, Hasan D, Messe S, Sheth K, Schwamm L, Smith E, Bhatt D, Fonarow G, Saver J, Xian Y, Grotta J. Mobile Stroke Unit Management in Patients With Acute Ischemic Stroke Eligible for Intravenous Thrombolysis. JAMA Neurology 2024, 81 PMID: 39466286, DOI: 10.1001/jamaneurol.2024.3659.Peer-Reviewed Original ResearchEmergency medical servicesEmergency medical service managementMobile stroke unitPrehospital managementSymptomatic intracranial hemorrhageHospital dischargeGlobal disabilityIn-hospital mortalityEfficacy end pointUtility-weighted modified Rankin scaleStroke unit managementAcute ischemic strokeIschemic strokePrimary analytic cohortDiagnosis of ischemic strokeIntravenous thrombolysisAmerican Heart AssociationEnd pointsGuidelines-StrokeUW-mRSSecondary efficacy end pointsMain OutcomesMedical servicesStroke unitAmbulation statusTwenty 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 initiativesClinically relevant findings on 24-h head CT after acute stroke therapy: The 24-h CT score.
Zhang B, King A, Voetsch B, Silverman S, Schwamm L, Ji X, Singhal A. Clinically relevant findings on 24-h head CT after acute stroke therapy: The 24-h CT score. International Journal Of Stroke 2024, 17474930241289992. PMID: 39324561, DOI: 10.1177/17474930241289992.Peer-Reviewed Original ResearchCT scoreCT findingsHead CTClinically relevant findingsFollow-up head CTRoutine head computed tomographyHead CT findingsHead computed tomographyConsecutive acute ischemic stroke patientsBlood pressure goalsAcute ischemic stroke patientsLow-risk groupMedium-risk groupAdministration of mannitolHigh-risk groupMultivariate logistic regressionAcute stroke therapyComprehensive stroke centerIschemic stroke patientsBlood glucose levelsCT abnormalitiesAntithrombotic treatmentRelevant findingsHypertonic salineRetrospective studyEvaluating the concordance between International Classification of Diseases, Tenth Revision Code and stroke severity as measured by the National Institutes of Health Stroke Scale
Taha M, Habib M, Lomachinsky V, Hadar P, Newhouse J, Schwamm L, Blacker D, Moura L. Evaluating the concordance between International Classification of Diseases, Tenth Revision Code and stroke severity as measured by the National Institutes of Health Stroke Scale. BMJ Neurology Open 2024, 6: e000831. PMID: 39363950, PMCID: PMC11448239, DOI: 10.1136/bmjno-2024-000831.Peer-Reviewed Original ResearchPaul Coverdell National Acute Stroke ProgramNational Institutes of Health Stroke ScaleInternational Classification of DiseasesClassification of DiseasesHealth Stroke ScaleInternational ClassificationICD-10Acute ischaemic strokeStroke severityICD-10 diagnosis codesStroke ScaleNIHSS scoreMeasures of stroke severityMedicare claims dataIntraclass correlation coefficientNational Institutes of Health Stroke Scale scoreNational InstituteMedicaid Services guidelinesService guidelinesStroke programClinical registryDiagnosis codesClaims dataSampled patientsExpert clinical evaluationFactors Underlying Reduced Hospitalizations for Myocardial Infarction During the COVID-19 Pandemic
Wilcock A, Zubizarreta J, Wadhera R, Yeh R, Zachrison K, Schwamm L, Mehrotra A. Factors Underlying Reduced Hospitalizations for Myocardial Infarction During the COVID-19 Pandemic. JAMA Cardiology 2024, 9: 914-920. PMID: 39083317, PMCID: PMC11292572, DOI: 10.1001/jamacardio.2024.2031.Peer-Reviewed Original ResearchHospital encountersAcute myocardial infarctionCare avoidanceShort-term acute careAcute myocardial infarction incidenceAcute myocardial infarction ratesTemporal trendsCOVID-19 pandemicPatient characteristicsTraditional Medicare claimsCross-sectional studyPandemic-related changesAMI incidenceCOVID-19 death ratesAcute careMyocardial infarctionMedicare claimsMain OutcomesExcess deathsExcess mortalityStudy samplePrepandemic levelsTraditional MedicareUnited StatesCOVID-19Reviewer Experience Detecting and Judging Human Versus Artificial Intelligence Content: The Stroke Journal Essay Contest
Silva G, Khera R, Schwamm L, Acampa M, Adelman E, Boltze J, Broderick J, Brodtmann A, Christensen H, Dalli L, Duncan K, Elgendy I, Ergul A, Goldstein L, Hinkle J, Johansen M, Jood K, Kasner S, Levine S, Li Z, Lip G, Marsh E, Muir K, Ospel J, Pera J, Quinn T, Räty S, Ranta A, Richards L, Romero J, Willey J, Hillis A, Veerbeek J. Reviewer Experience Detecting and Judging Human Versus Artificial Intelligence Content: The Stroke Journal Essay Contest. Stroke 2024, 55: 2573-2578. PMID: 39224979, PMCID: PMC11529699, DOI: 10.1161/strokeaha.124.045012.Peer-Reviewed Original ResearchConceptsArtificial intelligenceEditorial board membersAuthor typeTraditional peer reviewLanguage modelIntelligent contentAuthor attributionGeneral textAI expertiseHuman authorityImproved accuracyAuthor's identityAuthor's manuscriptScientific journalsEssay contestPeer reviewPerception of qualityAuthorshipNature of authorshipIntelligenceLLMScientific writingScientific essayEssay qualityEssayContemporary 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 hemorrhagePrestrokeTenecteplase versus alteplase for acute ischaemic stroke in the elderly patients: a post hoc analysis of the TRACE-2 trial
Xiong Y, Wang L, Pan Y, Wang M, Schwamm L, Duan C, Campbell B, Li S, Hao M, Wu N, Cao Z, Wu S, Li Z, Wang Y. Tenecteplase versus alteplase for acute ischaemic stroke in the elderly patients: a post hoc analysis of the TRACE-2 trial. Stroke And Vascular Neurology 2024, svn-2023-003048. PMID: 38858097, DOI: 10.1136/svn-2023-003048.Peer-Reviewed Original ResearchSymptomatic intracranial haemorrhageAcute ischaemic strokeModified Rankin ScaleElderly patientsPost hoc analysisAlteplase groupTenecteplase groupHoc analysisAlternative to alteplaseModified Rankin scale 0Ischaemic strokeRisk-benefit profileNon-inferiority clinical trialBenefit-risk profileEfficacy outcomesProportion of participantsReperfusion therapyIntracranial haemorrhageClinical trialsRankin ScaleSymptom onsetTenecteplaseAlteplaseIntravenous thrombolyticsSafety outcomesMapping the Ecological Terrain of Stroke Prehospital Delay: A Nationwide Registry Study
Dhand A, Reeves M, Mu Y, Rosner B, Rothfeld-Wehrwein Z, Nieves A, Dhongade V, Jarman M, Bergmark R, Semco R, Ader J, Marshall B, Goedel W, Fonarow G, Smith E, Saver J, Schwamm L, Sheth K. Mapping the Ecological Terrain of Stroke Prehospital Delay: A Nationwide Registry Study. Stroke 2024, 55: 1507-1516. PMID: 38787926, PMCID: PMC11299104, DOI: 10.1161/strokeaha.123.045521.Peer-Reviewed Original ResearchConceptsSocial Vulnerability IndexPrehospital delayHospital arrivalZIP Code Tabulation AreasEmergency medical servicesCommunity-level social vulnerabilityGuidelines-Stroke registryCommunity socioeconomic statusCommunity-level factorsPatient-level factorsNationwide registry studyAmerican Heart AssociationSocial vulnerabilityCox proportional hazards modelsSocially vulnerable areasAssociated with delaySocial determinantsProportional hazards modelAcute stroke treatmentGeospatial mappingSocioeconomic statusMedical servicesIncreased social vulnerabilityPrimary exposureQuartile 3Cost-effectiveness of atrial fibrillation detection with insertable cardiac monitors in large-artery or small-vessel disease stroke in the United Kingdom
Witte K, Schwamm L, Bernstein R, Reynolds M, Rose D, Lip G, Ozturk E, Villinger J, Rosemas S, Ziegler P, Yaghi S. Cost-effectiveness of atrial fibrillation detection with insertable cardiac monitors in large-artery or small-vessel disease stroke in the United Kingdom. EP Europace 2024, 26: euae102.603. PMCID: PMC11120381, DOI: 10.1093/europace/euae102.603.Peer-Reviewed Original ResearchQuality-adjusted life yearsInsertable cardiac monitorCHA2DS2-VASc scoreContinuous cardiac monitoringStroke eventsAtrial fibrillationCardiac monitoringNational Health Service (NHSBase case incremental cost-effectiveness ratioCHA2DS2-VAScInsertable cardiac monitor implantationDetection of AFHealth-related benefitsRisk of AFUnited KingdomCost-effectiveLarge-arteryRisk of cerebrovascular eventsIschemic strokeWillingness-to-pay thresholdsDetect atrial fibrillationIncremental cost-effectiveness ratioCost-effectiveness analysisProbabilistic sensitivity analysesSmall vessel disease strokeStrokeClassifier: ischemic stroke etiology classification by ensemble consensus modeling using electronic health records
Lee H, Schwamm L, Sansing L, Kamel H, de Havenon A, Turner A, Sheth K, Krishnaswamy S, Brandt C, Zhao H, Krumholz H, Sharma R. StrokeClassifier: ischemic stroke etiology classification by ensemble consensus modeling using electronic health records. Npj Digital Medicine 2024, 7: 130. PMID: 38760474, PMCID: PMC11101464, DOI: 10.1038/s41746-024-01120-w.Peer-Reviewed Original ResearchElectronic health recordsWeighted F1MIMIC-IIIClinical decision support systemsMulti-class classificationNatural language processingMIMIC-III datasetHealth recordsMachine learning classifiersDecision support systemArtificial intelligence toolsVascular neurologistsLearning classifiersBinary classificationCross-validation accuracyLanguage processingMeta-modelIntelligence toolsStroke prevention effortsAcute ischemic strokeStroke etiologySupport systemStroke etiology classificationClassification toolClassifierTwenty Years of Get With The Guidelines-Stroke: Celebrating Past Successes, Lessons Learned, and Future Challenges
Reeves M, Fonarow G, Smith E, Sheth K, Messe S, Schwamm L. Twenty Years of Get With The Guidelines-Stroke: Celebrating Past Successes, Lessons Learned, and Future Challenges. Stroke 2024, 55: 1689-1698. PMID: 38738376, PMCID: PMC11208062, DOI: 10.1161/strokeaha.124.046527.Peer-Reviewed Original ResearchMP-470553-002 ECONOMIC EVALUATION OF INSERTABLE CARDIAC MONITORS COMPARED TO SHORT-TERM MONITORING TO DETECT ATRIAL FIBRILLATION AFTER STROKE ATTRIBUTED TO LARGE-ARTERY OR SMALL-VESSEL DISEASE
Reynolds M, Pollit V, Schwamm L, Rose D, Witte K, Yahgi S, Cudworth S, Carpenter J, Rosemas S, Ziegler P, Neisen K, Franco N, Margetta J, Pouliot E, Bernstein R. MP-470553-002 ECONOMIC EVALUATION OF INSERTABLE CARDIAC MONITORS COMPARED TO SHORT-TERM MONITORING TO DETECT ATRIAL FIBRILLATION AFTER STROKE ATTRIBUTED TO LARGE-ARTERY OR SMALL-VESSEL DISEASE. Heart Rhythm 2024, 21: s117. DOI: 10.1016/j.hrthm.2024.03.486.Peer-Reviewed Original ResearchTrends in the Use of Medications for Secondary Ischemic Stroke Prevention in Denmark, 2005-2021.
Skajaa N, Laugesen K, Lauffenburger J, Schwamm L, Sørensen H, Patorno E. Trends in the Use of Medications for Secondary Ischemic Stroke Prevention in Denmark, 2005-2021. Neurology 2024, 102: e209309. PMID: 38648572, PMCID: PMC11226314, DOI: 10.1212/wnl.0000000000209309.Peer-Reviewed Original ResearchConceptsMedication useOral anticoagulant medicationsGlucose-lowering medication useFactors associated with medication useLipid-lowering medication useSevere strokeIschemic stroke hospitalizationsAntihypertensive medication useAnticoagulant medicationOlder patientsCare of patientsSodium-glucose cotransporter-2 inhibitorsGlucagon-like peptide-1 receptor agonistsStroke preventionAnticoagulant medication useLipid-loweringPeptide-1 receptor agonistsGlucose-loweringReduced life expectancyIschemic strokeCotransporter-2 inhibitorsStroke careCohort of patientsStroke hospitalizationsSecondary ischemic stroke preventionEvaluating the Concordance Between International Classification of Diseases, Tenth Revision Code, and Stroke Severity as Measured by the National Institutes of Health Stroke Scale (P1-5.013)
Taha M, Habib M, Torres V, Hadar P, Newhouse J, Schwamm L, Blacker D, Moura L. Evaluating the Concordance Between International Classification of Diseases, Tenth Revision Code, and Stroke Severity as Measured by the National Institutes of Health Stroke Scale (P1-5.013). Neurology 2024, 102 DOI: 10.1212/wnl.0000000000206137.Peer-Reviewed Original ResearchPatterns of Benzodiazepine Initiation Among Older Acute Ischemic Stroke Survivors (P1-10.006)
Torres V, Brooks J, Donahue M, Blacker D, Schwamm L, Hsu J, Newhouse J, Moura L. Patterns of Benzodiazepine Initiation Among Older Acute Ischemic Stroke Survivors (P1-10.006). Neurology 2024, 102 DOI: 10.1212/wnl.0000000000206364.Peer-Reviewed Original ResearchBenzodiazepine Initiation and the Elevated Risk of Falls and Fall-related Injuries in Older Adults Following Acute Ischemic Stroke (P2-5.008)
Sun S, Smith L, Schwamm L, Moura L, Haneuse S. Benzodiazepine Initiation and the Elevated Risk of Falls and Fall-related Injuries in Older Adults Following Acute Ischemic Stroke (P2-5.008). Neurology 2024, 102 DOI: 10.1212/wnl.0000000000204937.Peer-Reviewed Original ResearchAssociation of Traditional and Nontraditional Risk Factors in the Development of Strokes Among Young Adults by Sex and Age Group: A Retrospective Case-Control Study
Leppert M, Poisson S, Scarbro S, Suresh K, Lisabeth L, Putaala J, Schwamm L, Daugherty S, Bradley C, Burke J, Ho P. Association of Traditional and Nontraditional Risk Factors in the Development of Strokes Among Young Adults by Sex and Age Group: A Retrospective Case-Control Study. Circulation Cardiovascular Quality And Outcomes 2024, 17: e010307. PMID: 38529631, PMCID: PMC11021148, DOI: 10.1161/circoutcomes.123.010307.Peer-Reviewed Original ResearchConceptsTraditional risk factorsDevelopment of strokeNontraditional risk factorsCase-control studyRisk factorsRetrospective case-control studyAge groupsContribution of traditional risk factorsYoung adultsConditional logistic regression modelsPopulation attributable riskCount of risk factorsStroke-free controlsAll Payer Claims DatabaseAssociation of strokeColorado All Payer Claims DatabaseLogistic regression modelsPayer Claims DatabaseIncreased risk of strokeAttributable riskRisk of strokeStroke eventsYears of ageInsurance typeIncreased riskThrombolysis for Wake-Up Stroke Versus Non–Wake-Up Unwitnessed Stroke: EOS Individual Patient Data Meta-Analysis
Kamogawa N, Miwa K, Toyoda K, Jensen M, Inoue M, Yoshimura S, Fukuda-Doi M, Kitazono T, Boutitie F, Ma H, Ringleb P, Wu O, Schwamm L, Warach S, Hacke W, Davis S, Donnan G, Gerloff C, Thomalla G, Koga M, Investigators O. Thrombolysis for Wake-Up Stroke Versus Non–Wake-Up Unwitnessed Stroke: EOS Individual Patient Data Meta-Analysis. Stroke 2024, 55: 895-904. PMID: 38456303, PMCID: PMC10978262, DOI: 10.1161/strokeaha.123.043358.Peer-Reviewed Original ResearchConceptsSymptomatic intracranial hemorrhageIntracranial hemorrhageIntravenous thrombolysisFavorable outcomeUnwitnessed strokeNon-WUSFrequency of favorable outcomesIndividual patient-data meta-analysisMultivariate logistic regression analysisModified Rankin Scale scoreSafety of intravenous thrombolysisRankin Scale scoreEffect of intravenous thrombolysisIntravenous thrombolysis groupLogistic regression analysisUnknown-onset strokeRandomized controlled trialsNo significant differencePatient-level dataData meta-analysisStandard treatmentInsufficient statistical powerPatientsSafety outcomesControlled trialsReimagining Stroke Quality of Care in the Age of Artificial Intelligence and Digital Enablement
Schwamm L. Reimagining Stroke Quality of Care in the Age of Artificial Intelligence and Digital Enablement. Stroke 2024, 55: 1683-1685. PMID: 38380550, DOI: 10.1161/strokeaha.123.044251.Peer-Reviewed Original Research