2024
Machine Learning Models for 3-Month Outcome Prediction Using Radiomics of Intracerebral Hemorrhage and Perihematomal Edema from Admission Head Computed Tomography (CT)
Dierksen F, Sommer J, Tran A, Lin H, Haider S, Maier I, Aneja S, Sanelli P, Malhotra A, Qureshi A, Claassen J, Park S, Murthy S, Falcone G, Sheth K, Payabvash S. Machine Learning Models for 3-Month Outcome Prediction Using Radiomics of Intracerebral Hemorrhage and Perihematomal Edema from Admission Head Computed Tomography (CT). Diagnostics 2024, 14: 2827. PMID: 39767188, PMCID: PMC11674633, DOI: 10.3390/diagnostics14242827.Peer-Reviewed Original ResearchIntegrated discrimination indexNet reclassification indexPerihematomal edemaHead computed tomographyIntracerebral hemorrhageComputed tomographyClinical variablesClinical predictors of poor outcomeOutcome predictionAcute supratentorial intracerebral hemorrhageAdmission head computed tomographyRadiomic featuresNon-contrast head computed tomographyPredictors of poor outcomeModified Rankin Scale scoreIntracerebral hemorrhage scoreSupratentorial intracerebral hemorrhageIntracerebral hemorrhage patientsClinical risk factorsRankin Scale scoreReceiver operating characteristic areaOperating characteristics areaSecondary brain injuryHematoma evacuationPatient selectionSex Modifies the Severity and Outcome of Spontaneous Intracerebral Hemorrhage
Rivier C, Renedo D, Marini S, Magid‐Bernstein J, de Havenon A, Rosand J, Hanley D, Ziai W, Mayer S, Woo D, Sansing L, Sheth K, Anderson C, Falcone G. Sex Modifies the Severity and Outcome of Spontaneous Intracerebral Hemorrhage. Annals Of Neurology 2024, 97: 232-241. PMID: 39499118, DOI: 10.1002/ana.27123.Peer-Reviewed Original ResearchRisk of hematoma expansionHighest risk of hematoma expansionRisk of poor outcomesIntracerebral hemorrhageHematoma expansionHigh riskMale sexPoor outcomeOutcome of spontaneous intracerebral hemorrhageClinical characteristics of patientsStudies of intracerebral hemorrhageNon-traumatic intracerebral hemorrhageIndividual patient data meta-analysisPatient data meta-analysisSpontaneous intracerebral hemorrhageSingle-center studyIntracerebral hemorrhage patientsHigh risk of expansionCharacteristics of patientsIntracerebral hemorrhage severityPoor functional outcomeRandomized clinical trialsData meta-analysisHemorrhage volumeClinical characteristicsDeep learning survival model predicts outcome after intracerebral hemorrhage from initial CT scan
Chen Y, Rivier C, Mora S, Lopez V, Payabvash S, Sheth K, Harloff A, Falcone G, Rosand J, Mayerhofer E, Anderson C. Deep learning survival model predicts outcome after intracerebral hemorrhage from initial CT scan. European Stroke Journal 2024, 10: 225-235. PMID: 38880882, PMCID: PMC11569453, DOI: 10.1177/23969873241260154.Peer-Reviewed Original ResearchIntracerebral hemorrhage scoreNon-contrast CT scanIntracerebral hemorrhageCT scanFUNC scoreIntracerebral hemorrhage patientsNon-contrast CTFunctional impairmentSevere disabilityDependent living statusLong-term functional impairmentC-indexPrognostic toolFunctional outcomesTreatment decisionsAcute settingClinical implementationRehabilitation strategiesDependent livingPatientsPredicting functional impairmentLong-term care needsPlanning of patient careDeep learning modelsHemorrhagePrognostic biomarkers of intracerebral hemorrhage identified using targeted proteomics and machine learning algorithms
Misra S, Kawamura Y, Singh P, Sengupta S, Nath M, Rahman Z, Kumar P, Kumar A, Aggarwal P, Srivastava A, Pandit A, Mohania D, Prasad K, Mishra N, Vibha D. Prognostic biomarkers of intracerebral hemorrhage identified using targeted proteomics and machine learning algorithms. PLOS ONE 2024, 19: e0296616. PMID: 38829877, PMCID: PMC11146689, DOI: 10.1371/journal.pone.0296616.Peer-Reviewed Original ResearchConceptsIntracerebral hemorrhagePoor outcomePrognostic biomarker of ICHBiomarker of intracerebral hemorrhageHazard ratioOdds ratioShort-term poor outcomePrognostic of patient outcomeMMP-2Multivariate Cox regression modelICH prognosisInternal validation of prediction modelsModified Rankin Scale scoreIntracerebral hemorrhage patientsRankin Scale scoreUCH-L1Confidence intervalsCox regression modelsMultivariate logistic regressionProtein biomarkersIGFBP-3Regression modelsPrognostic outcomesSerum biomarkersClinical variables
2023
Emergent external ventricular drain placement in patients with factor Xa inhibitor-associated intracerebral hemorrhage after reversal with andexanet alfa
Ammar A, Elsamadicy A, Ammar M, Reeves B, Koo A, Falcone G, Hwang D, Petersen N, Kim J, Beekman R, Prust M, Magid-Bernstein J, Acosta J, Herbert R, Sheth K, Matouk C, Gilmore E. Emergent external ventricular drain placement in patients with factor Xa inhibitor-associated intracerebral hemorrhage after reversal with andexanet alfa. Clinical Neurology And Neurosurgery 2023, 226: 107621. PMID: 36791588, DOI: 10.1016/j.clineuro.2023.107621.Peer-Reviewed Original ResearchConceptsAndexanet alfaExtra-axial hemorrhageEVD placementThrombotic eventsNew hemorrhagePrimary safety outcomeExternal ventricular drain placementLarge prospective studiesIntensive care unitIntracerebral hemorrhage patientsVentricular drain placementBolus patientsHospital lengthHospital LOSICU LOSTract hemorrhageRankin scoreSecondary outcomesAdult patientsBolus groupPrimary outcomeCare unitIntracerebral hemorrhageLong administration timeHemorrhage patients
2021
End-of-Life Care Decision-Making in Stroke
Gao L, Zhao C, Hwang D. End-of-Life Care Decision-Making in Stroke. Frontiers In Neurology 2021, 12: 702833. PMID: 34650502, PMCID: PMC8505717, DOI: 10.3389/fneur.2021.702833.Peer-Reviewed Original ResearchStroke patientsImmediate post-stroke periodIntensive care unit careLong-term functional outcomeCare decisionsCode status changePost-stroke periodIntensive care unitIntracerebral hemorrhage patientsLong-term disabilityLife care discussionsLife-sustaining therapyCause of deathLife care decisionsClinician's subjectivityIschemic strokeUnit careCare unitHemorrhage patientsPatient survivalFunctional outcomeProvider recommendationPatient preferencesCare discussionsTreatment goalsAdmission Hemoglobin Levels Are Associated With Functional Outcome in Spontaneous Intracerebral Hemorrhage
Acosta JN, Leasure AC, Kuohn LR, Both CP, Petersen NH, Sansing LH, Matouk CC, Testai F, Langefeld CD, Woo D, Kamel H, Murthy SB, Qureshi A, Mayer SA, Sheth KN, Falcone GJ. Admission Hemoglobin Levels Are Associated With Functional Outcome in Spontaneous Intracerebral Hemorrhage. Critical Care Medicine 2021, 49: 828-837. PMID: 33591003, PMCID: PMC8611893, DOI: 10.1097/ccm.0000000000004891.Peer-Reviewed Original ResearchConceptsAdmission hemoglobin levelsHemoglobin levelsNontraumatic intracerebral hemorrhageIntracerebral hemorrhageHematoma volumePoor outcomeHematoma expansionIntracerebral hemorrhage patientsPredictors of outcomeSpontaneous intracerebral hemorrhageIndividual patient dataHigher hemoglobin levelsAdmission hematoma volumeExposure of interestDose-response analysisAdmission hemoglobinRankin ScalePrimary outcomeHemorrhage patientsFunctional outcomeRepeat CTClinical trialsObservational studyHemorrhage sizeBetter outcomes
2020
Ultra‐Early Blood Pressure Reduction Attenuates Hematoma Growth and Improves Outcome in Intracerebral Hemorrhage
Li Q, Warren AD, Qureshi AI, Morotti A, Falcone GJ, Sheth KN, Shoamanesh A, Dowlatshahi D, Viswanathan A, Goldstein JN. Ultra‐Early Blood Pressure Reduction Attenuates Hematoma Growth and Improves Outcome in Intracerebral Hemorrhage. Annals Of Neurology 2020, 88: 388-395. PMID: 32453453, PMCID: PMC8697414, DOI: 10.1002/ana.25793.Peer-Reviewed Original ResearchConceptsBlood pressure reductionBlood pressure treatmentOnset of symptomsIntensive Blood Pressure ReductionIntensive blood pressure treatmentHematoma growthNicardipine treatmentPressure reductionBetter outcomesModified Rankin scale score distributionRankin Scale score distributionStandard blood pressure treatmentElevated blood pressureStandard treatment groupSubgroup of patientsIntracerebral hemorrhage patientsPost-hoc exploratory analysisAnn NeurolAntihypertensive treatmentIntravenous nicardipineScale score distributionBlood pressureIntracerebral hemorrhageMultivariable analysisDecreased riskRural–Urban Disparities in Intracerebral Hemorrhage Mortality in the USA: Preliminary Findings from the National Inpatient Sample
Otite F, Akano E, Akintoye E, Khandelwal P, Malik A, Chaturvedi S, Rosand J. Rural–Urban Disparities in Intracerebral Hemorrhage Mortality in the USA: Preliminary Findings from the National Inpatient Sample. Neurocritical Care 2020, 32: 715-724. PMID: 32232726, PMCID: PMC7223184, DOI: 10.1007/s12028-020-00950-2.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overAphasiaCerebral HemorrhageComorbidityCraniotomyDeglutition DisordersFemaleHealthcare DisparitiesHospital Bed CapacityHospital MortalityHospitals, RuralHospitals, UrbanHumansHydrocephalusMaleMiddle AgedRespiration, ArtificialRisk FactorsUnited StatesYoung AdultConceptsNational Inpatient SampleSex-adjusted mortalityUrban hospitalRural hospitalsICH patientsInpatient SampleJoinpoint regressionIntracerebral hemorrhage mortalityMultivariable-adjusted modelsOdds of mortalityIntracerebral hemorrhage patientsCases of ICHHospital deathHospital mortalityMultivariable adjustmentUrban patientsRural patientsStroke careHemorrhage patientsMedicare insuranceRural-urban disparitiesPatientsResultsFrom 2004HospitalMortality gap
2019
Deep Learning for Automated Measurement of Hemorrhage and Perihematomal Edema in Supratentorial Intracerebral Hemorrhage
Dhar R, Falcone GJ, Chen Y, Hamzehloo A, Kirsch EP, Noche RB, Roth K, Acosta J, Ruiz A, Phuah CL, Woo D, Gill TM, Sheth KN, Lee JM. Deep Learning for Automated Measurement of Hemorrhage and Perihematomal Edema in Supratentorial Intracerebral Hemorrhage. Stroke 2019, 51: 648-651. PMID: 31805845, PMCID: PMC6993878, DOI: 10.1161/strokeaha.119.027657.Peer-Reviewed Original ResearchConceptsSupratentorial intracerebral hemorrhagePerihematomal edemaIntracerebral hemorrhagePHE volumeResults Two hundred twentyIntracerebral Hemorrhage (ERICH) studyMechanism of injuryIntracerebral hemorrhage patientsSpontaneous intracerebral hemorrhageLarge cohort studyComputed tomography scanSecondary outcomesCohort studyPrimary outcomeHemorrhage patientsSecondary injuryTomography scanHundred twentyMedian volumeLarge cohortHemorrhagePatientsQuantification of hemorrhageFirst cohortDisease biology
2018
Characteristics of Surrogate Decision Makers Selecting Life-sustaining Therapy for Severe Intracerebral Hemorrhage Patients: a Neuropalliative Care Survey of the US Population (S7.003)
Hwang D, Knies A, White D, Holloway R, Sheth K, Fraenkel L. Characteristics of Surrogate Decision Makers Selecting Life-sustaining Therapy for Severe Intracerebral Hemorrhage Patients: a Neuropalliative Care Survey of the US Population (S7.003). Neurology 2018, 90 DOI: 10.1212/wnl.90.15_supplement.s7.003.Peer-Reviewed Original ResearchIntracerebral hemorrhage patientsLife-sustaining therapyHemorrhage patientsCare SurveyUS populationPatientsTherapy
2017
Variability in Gastrostomy Tube Placement for Intracerebral Hemorrhage Patients at US Hospitals
Hwang DY, George BP, Kelly AG, Schneider EB, Sheth KN, Holloway RG. Variability in Gastrostomy Tube Placement for Intracerebral Hemorrhage Patients at US Hospitals. Journal Of Stroke And Cerebrovascular Diseases 2017, 27: 978-987. PMID: 29221969, DOI: 10.1016/j.jstrokecerebrovasdis.2017.11.001.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overCerebral HemorrhageClinical Decision-MakingDatabases, FactualFemaleGastrostomyHealthcare DisparitiesHospitalsHumansLogistic ModelsMaleMiddle AgedMultivariate AnalysisOdds RatioPractice Patterns, Physicians'Process Assessment, Health CareRetrospective StudiesTime FactorsUnited StatesYoung AdultConceptsGastrostomy tube placementTube placementGastrostomy tubeICH patientsIntracerebral hemorrhageUS hospitalsMultilevel multivariable regression modelsHospital random effectsNationwide Inpatient SampleIntracerebral hemorrhage patientsMultivariable regression modelsLocal practice patternsMedian odds ratioICH hospitalizationsHospital factorsHospital covariatesRegression modelsHemorrhage patientsICH admissionsInpatient SampleOdds ratioPlacement ratesPractice patternsMedian increasePatientsSafety and Costs of Stroke Unit Admission for Select Acute Intracerebral Hemorrhage Patients
Fehnel C, Glerum K, Wendell L, Potter N, Silver B, Khan M, Saad A, Yaghi S, Jones R, Furie K, Thompson B. Safety and Costs of Stroke Unit Admission for Select Acute Intracerebral Hemorrhage Patients. The Neurohospitalist 2017, 8: 12-17. PMID: 29276557, PMCID: PMC5734507, DOI: 10.1177/1941874417712158.Peer-Reviewed Original ResearchIntensive care unitStroke unit admissionIntracerebral hemorrhage patientsUnit admissionHemorrhage patientsFunctional outcomeAcute intracerebral hemorrhage patientsDirect patient costsPoor functional statusRetrospective cohort studyRate of complicationsPoor functional outcomeSkilled nursing facilitiesDirect inpatient costsMean mRSHospital lengthICU groupBaseline characteristicsCohort studyDischarge dispositionPatient characteristicsSecondary outcomesSelect patientsConsecutive patientsPrimary outcome
2015
Rate of Contrast Extravasation on Computed Tomographic Angiography Predicts Hematoma Expansion and Mortality in Primary Intracerebral Hemorrhage
Brouwers HB, Battey TW, Musial HH, Ciura VA, Falcone GJ, Ayres AM, Vashkevich A, Schwab K, Viswanathan A, Anderson CD, Greenberg SM, Pomerantz SR, Ortiz CJ, Goldstein JN, Gonzalez RG, Rosand J, Romero JM. Rate of Contrast Extravasation on Computed Tomographic Angiography Predicts Hematoma Expansion and Mortality in Primary Intracerebral Hemorrhage. Stroke 2015, 46: 2498-2503. PMID: 26243220, PMCID: PMC4550492, DOI: 10.1161/strokeaha.115.009659.Peer-Reviewed Original ResearchConceptsPrimary intracerebral hemorrhageHematoma expansionContrast extravasationIntracerebral hemorrhageSpot signExtravasation rateTomographic angiographyConsecutive intracerebral hemorrhage patientsML/minContrast extravasation rateAcute intracerebral hemorrhageIntracerebral hemorrhage patientsMultivariable logistic regressionRate of bleedingIntracerebral hemorrhage volumeSpot sign presenceHospital mortalityMultivariable analysisHemorrhage patientsPostcontrast CTHemorrhage volumeSemiautomated softwareMortalityLogistic regressionHemorrhage
2014
Hospitalized Hemorrhagic Stroke Patients with Renal Insufficiency: Clinical Characteristics, Care Patterns, and Outcomes
Ovbiagele B, Schwamm L, Smith E, Grau-Sepulveda M, Saver J, Bhatt D, Hernandez A, Peterson E, Fonarow G. Hospitalized Hemorrhagic Stroke Patients with Renal Insufficiency: Clinical Characteristics, Care Patterns, and Outcomes. Journal Of Stroke And Cerebrovascular Diseases 2014, 23: 2265-2273. PMID: 25158677, DOI: 10.1016/j.jstrokecerebrovasdis.2014.04.016.Peer-Reviewed Original ResearchConceptsChronic kidney diseaseNormal renal functionICH patientsClinical characteristicsRenal functionKidney diseaseCare patternsDeep venous thrombosis prophylaxisGuidelines-Stroke programGWTG-Stroke programVenous thrombosis prophylaxisThird of patientsGlomerular filtration rateHemorrhagic stroke patientsNormal kidney functionIntracerebral hemorrhage patientsSmoking cessation interventionHospital mortalityThrombosis prophylaxisHospital outcomesRenal dysfunctionRenal insufficiencyInpatient mortalityClinical outcomesComorbid conditions
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