2021
Expedited and Comprehensive Management of Low-Risk TIA Patients in the Emergency Department is Safe and Less Costly
Garg A, Maran I, Amin H, Vlieks K, Neuschatz K, Coppola A, Poskus K, Johnson J, Davis M, Minja F, Schindler J, Sansing LH, Malhotra A, Jasne AS, Sharma R. Expedited and Comprehensive Management of Low-Risk TIA Patients in the Emergency Department is Safe and Less Costly. Journal Of Stroke And Cerebrovascular Diseases 2021, 30: 106016. PMID: 34325273, DOI: 10.1016/j.jstrokecerebrovasdis.2021.106016.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overClinical ProtocolsCost SavingsCost-Benefit AnalysisDecision Support TechniquesDelivery of Health Care, IntegratedEmergency Service, HospitalFeasibility StudiesFemaleHospital CostsHumansIschemic Attack, TransientLength of StayMaleMiddle AgedOutcome and Process Assessment, Health CarePredictive Value of TestsRetrospective StudiesRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeTriageConceptsLow-risk TIA patientsTransient ischemic attackTIA patientsEmergency roomAcademic comprehensive stroke centerSingle-center cohort studyPre-pathway groupComprehensive stroke centerClinical practice recommendationsLength of stayOutcomes of interestImpending strokeIschemic attackOutpatient echocardiogramRapid outpatientTIA admissionsEchocardiogram findingsEchocardiographic findingsStroke clinicCohort studyStroke centersNeurovascular eventsEmergency departmentFinal diagnosisHospital costsDrip-and-ship versus mothership for endovascular treatment of acute stroke: A comparative effectiveness analysis
Wu X, Wira C, Matouk C, Forman H, Gandhi D, Sanelli P, Schindler J, Malhotra A. Drip-and-ship versus mothership for endovascular treatment of acute stroke: A comparative effectiveness analysis. International Journal Of Stroke 2021, 17: 315-322. PMID: 33759645, DOI: 10.1177/17474930211008701.Peer-Reviewed Original ResearchConceptsComprehensive stroke centerPrimary stroke centerAcute stroke patientsNearest comprehensive stroke centerAcute strokeMothership strategyStroke centersStroke patientsPlace of onsetHealth benefitsMarkov decision-analytic modelComparative effectiveness analysisRecent medical literatureMultiple sensitivity analysesDecision analytic modelMothership modelPrimary outcomeEndovascular treatmentPrehospital triageSudden onsetPatientsMedical literatureStrokeShip strategyTarget population
2020
Stroke Systems of Care
Amin H, Schindler J. Stroke Systems of Care. 2020, 243-245. DOI: 10.1007/978-3-030-52552-1_20.ChaptersBrain Attack CoalitionStroke careAmerican Heart Association/American Stroke AssociationEffective acute stroke careAcute stroke carePrimary stroke centerAmerican Stroke AssociationHospital outcomesStroke centersStroke measuresVascular neurologistsStroke AssociationPrehospital settingStroke systemsT-PAMedicaid ServicesJoint CommissionCareBetter standardizationOutcomesInitial recommendationsEffective administrationMedicationsNeurologistsMixed outcomesStroke Code Presentations, Interventions, and Outcomes Before and During the COVID-19 Pandemic
Jasne AS, Chojecka P, Maran I, Mageid R, Eldokmak M, Zhang Q, Nystrom K, Vlieks K, Askenase M, Petersen N, Falcone GJ, Wira CR, Lleva P, Zeevi N, Narula R, Amin H, Navaratnam D, Loomis C, Hwang DY, Schindler J, Hebert R, Matouk C, Krumholz HM, Spudich S, Sheth KN, Sansing LH, Sharma R. Stroke Code Presentations, Interventions, and Outcomes Before and During the COVID-19 Pandemic. Stroke 2020, 51: 2664-2673. PMID: 32755347, PMCID: PMC7446978, DOI: 10.1161/str.0000000000000347.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBetacoronavirusBrain IschemiaCohort StudiesComorbidityConnecticutCoronary Artery DiseaseCoronavirus InfectionsCOVID-19DyslipidemiasEmergency Medical ServicesEthnicityFemaleHumansHypertensionIncomeInsurance, HealthIntracranial HemorrhagesMaleMedically UninsuredMiddle AgedOutcome and Process Assessment, Health CarePandemicsPneumonia, ViralRetrospective StudiesSARS-CoV-2Severity of Illness IndexStrokeSubstance-Related DisordersTelemedicineThrombectomyThrombolytic TherapyTime-to-TreatmentConceptsComprehensive stroke centerStroke codePatient characteristicsStroke severityStroke code patientsHistory of hypertensionStroke-like symptomsCoronary artery diseaseCoronavirus disease 2019 (COVID-19) pandemicPatient-level dataLower median household incomePublic health initiativesDisease 2019 pandemicCOVID-19 pandemicRace/ethnicityCode patientsHospital presentationPublic health insuranceRankin ScaleStroke centersArtery diseaseReperfusion timeStroke symptomsEarly outcomesConnecticut hospitals
2017
Acute Ischemic Stroke
Nyström K, Schindler J. Acute Ischemic Stroke. 2017, 93-115. DOI: 10.1007/978-3-319-48669-7_6.ChaptersAcute ischemic strokeIschemic strokeAdvanced practice cliniciansStroke teamStroke carePractice cliniciansAcute neurological deficitsAcute stroke presentationsPotential stroke patientsSubsequent inpatient careIntravenous thrombolytic therapyAcute stroke careAcute stroke teamEmergency department physiciansCertified stroke centersNeurological deficitsStroke centersNeurological examinationStroke presentationInitial treatmentStroke patientsThrombolytic therapyDepartment physiciansStroke systemsInpatient care
2016
Stroke Systems of Care
Amin H, Schindler J. Stroke Systems of Care. 2016, 185-188. DOI: 10.1007/978-3-319-39605-7_20.ChaptersBrain Attack CoalitionStroke careAmerican Heart Association/American Stroke AssociationEffective acute stroke careAcute stroke carePrimary stroke centerAmerican Stroke AssociationHospital outcomesStroke centersStroke measuresVascular neurologistsStroke AssociationPrehospital settingStroke systemsT-PAMedicaid ServicesJoint CommissionCareBetter standardizationOutcomesInitial recommendationsEffective administrationMedicationsNeurologistsMixed outcomes
2015
On- versus Off-Hour Patient Cohorts at a Primary Stroke Center: Onset-to-Treatment Duration and Clinical Outcomes after IV Thrombolysis
Asuzu D, Nystrӧm K, Amin H, Schindler J, Wira C, Greer D, Fang NF, Halliday J, Sheth KN. On- versus Off-Hour Patient Cohorts at a Primary Stroke Center: Onset-to-Treatment Duration and Clinical Outcomes after IV Thrombolysis. Journal Of Stroke And Cerebrovascular Diseases 2015, 25: 447-451. PMID: 26654664, DOI: 10.1016/j.jstrokecerebrovasdis.2015.10.017.Peer-Reviewed Original ResearchConceptsSymptomatic intracerebral hemorrhagePrimary stroke centerClinical outcomesStroke centersStroke severitySymptom onsetStroke careStroke patientsPatient cohortIntravenous recombinant tissue plasminogen activator (rt-PA) therapyTreatment durationRecombinant tissue plasminogen activator therapyHealth Stroke Scale scoreTissue plasminogen activator therapyConsistent quality careBaseline National InstitutesStroke Scale scoreAcute stroke careIschemic stroke patientsPlasminogen activator therapyMann-Whitney testSICH rateAcute strokeIschemic strokeConsecutive patientsComparison of On-hour vs Off-hour Patient Cohorts at a Primary Stroke Center: Onset-To-Treatment Duration and Clinical Outcomes after IV Thrombolysis (S21.005)
Nystrom K, Asuzu D, Amin H, Schindler J, Wira C, Greer D, Chi N, Halliday J, Sheth K. Comparison of On-hour vs Off-hour Patient Cohorts at a Primary Stroke Center: Onset-To-Treatment Duration and Clinical Outcomes after IV Thrombolysis (S21.005). Neurology 2015, 84 DOI: 10.1212/wnl.84.14_supplement.s21.005.Peer-Reviewed Original ResearchCohort-Based Identification of Predictors of Symptomatic Intracerebral Hemorrhage After IV Thrombolysis
Asuzu D, Nyström K, Amin H, Schindler J, Wira C, Greer D, Chi NF, Halliday J, Sheth KN. Cohort-Based Identification of Predictors of Symptomatic Intracerebral Hemorrhage After IV Thrombolysis. Neurocritical Care 2015, 23: 394-400. PMID: 25691004, DOI: 10.1007/s12028-015-0121-1.Peer-Reviewed Original ResearchConceptsRt-PA therapyEarly CT hypodensityHyperdense MCA signCT hypodensityIschemic strokeIndependent predictorsRisk of sICHSymptomatic intracerebral hemorrhageAcute ischemic strokeVisual field deficitsNew independent predictorAdditional independent predictorsCase-control studyIdentification of predictorsLevel of consciousnessTwo-sample t-testMann-Whitney testAntithrombolytic therapyStroke centersField deficitsSerious complicationsIntracerebral hemorrhageClinical parametersIntracranial hemorrhageTherapy