A5051292940- Acute Ischemic Stroke Management
- Stroke Rehabilitation and Recovery
- Cerebrovascular and Carotid Artery Diseases
- Cardiovascular Health and Risk Factors
- Traumatic Brain Injury and Neurovascular Disturbances
- Venous Thromboembolism Diagnosis and Management
- Neurological Disorders and Treatments
- Healthcare Systems and Practices
- Antiplatelet Therapy and Cardiovascular Diseases
- Trauma and Emergency Care Studies
- Intracranial Aneurysms: Treatment and Complications
- Intracerebral and Subarachnoid Hemorrhage Research
- Healthcare Systems and Public Health
- Atrial Fibrillation Management and Outcomes
- Botulinum Toxin and Related Neurological Disorders
- Blood Coagulation and Thrombosis Mechanisms
- Blood Pressure and Hypertension Studies
- Cerebral Palsy and Movement Disorders
- Neurological Disease Mechanisms and Treatments
- Cardiovascular Health and Disease Prevention
- Esophageal and GI Pathology
- Infective Endocarditis Diagnosis and Management
- Cerebrospinal fluid and hydrocephalus
- Artificial Intelligence in Healthcare
- Peripheral Artery Disease Management
University of Cincinnati
2015-2024
University of Cincinnati Medical Center
2014-2024
Columbia University Irving Medical Center
2023
Indiana University – Purdue University Indianapolis
2016-2023
Cincinnati Children's Hospital Medical Center
2010-2023
Providence College
2023
Yale University
2022-2023
Northwestern University
2023
Soroka Medical Center
2022-2023
University of Kansas Medical Center
2022-2023
We describe temporal trends in stroke incidence stratified by age from our population-based epidemiology study. hypothesized that younger adults (age 20-54) increased over time, most notably between 1999 and 2005.
Background and Purpose— Transient ischemic attacks (TIAs) have been shown to be a strong predictor of subsequent stroke death. We present the incidence short-term prognosis TIA within large population with significant proportion minorities out-of-hospital TIA. Methods— cases were identified between July 1, 1993 June 30, 1994 from Greater Cincinnati/Northern Kentucky 1.3 million inhabitants by previously published surveillance methods, including inpatient events. Incidence rates adjusted 1990...
To define temporal trends in the incidence of anticoagulant-associated intracerebral hemorrhage (AAICH) during 1990s and relate them to rates cardioembolic ischemic stroke.We identified all patients hospitalized with first-ever (ICH) greater Cincinnati 1988, from July 1993 through June 1994, 1999. AAICH was defined as ICH receiving warfarin or heparin. Patients same region stroke mechanism were 1993/1994 Incidence calculated adjusted 2000 US population. Estimates distribution United States...
Background and Purpose— Excess mortality resulting from stroke is an important reason why blacks have higher age-adjusted rates than whites. This observation has 2 possible explanations: Strokes occur more commonly among or after stroke. Our population-based epidemiological study set in the Greater Cincinnati/Northern Kentucky region of 1.31 million people, which representative US white black populations with regard to many demographic socioeconomic characteristics. Methods— Hospitalized...
<b><i>Background:</i></b> Population-based studies have estimated that about 15% of ischemic strokes are caused by large-vessel cerebrovascular disease. We determined the types atherosclerosis responsible for in a population-based stroke study. <b><i>Methods:</i></b> Patients with first-ever or recurrent Greater Cincinnati area were identified during 2005 at all local hospitals. Study physicians assigned subtypes. Overall event rates and...
Although other studies (in largely white populations) have found that stroke incidence declined during the 1990s, we previously reported in our population (18% of which was black) did not change decade and rates blacks were significantly higher than whites. We sought to update temporal trends by adding new data obtained from large, biracial 2005. The objective this study examine case-fatality within a large over time comparing 1993 1994, 1999,
<h3>Objective:</h3> Previous studies have estimated that wake-up strokes comprise 8%to 28% of all ischemic strokes, but these were either small or not population-based. We sought to establish the proportion and event rate in a large population-based study compare patients who awoke with stroke symptoms those awake at time onset. <h3>Methods:</h3> First-time recurrent among residents Greater Cincinnati/Northern Kentucky region (population 1.3 million) 2005 identified using International...
OBJECTIVE— Diabetes is a well known risk factor for stroke, but the impact of diabetes on stroke incidence rates not known. This study uses population-based to describe epidemiology ischemic in diabetic patients. RESEARCH DESIGN AND METHODS— Hospitalized cases were ascertained by ICD-9 discharge codes, prospective screening emergency department admission logs, and review coroner’s cases. A sampling scheme was used ascertain out-of-hospital setting. All potential underwent detailed chart...
Background and Purpose— Acute ischemic stroke patients are infrequently treated with recombinant tissue plasminogen activator (rtPA). We present unique population-based data regarding the eligibility of for rtPA treatment. Methods— All strokes presenting to an emergency department (ED) within a biracial population 1.3 million were identified. The patient was considered eligible on basis exclusion criteria from National Institute Neurological Disorders Stroke trial. Results— Of 2308 strokes,...
Background and Purpose— Blacks have an excess burden of stroke compared with whites; however, data comparing ischemic subtypes among the 2 groups are limited typically involve relative frequencies. The objective this study is to compare incidence rates between blacks whites within a large, representative, biracial population. Methods— Greater Cincinnati/Northern Kentucky Stroke Study designed measure trends all strokes well-defined, Hospitalized cases were ascertained by International...
Summary Purpose: The incidence of seizures within 24 h acute stroke has not been studied extensively. We aimed to establish the poststroke in a biracial cohort and determine whether seizure occurrence differs by race/ethnicity, subtype, and/or localization. Methods: identified all cases between July 1993 June 1994 1999 population Greater Cincinnati metropolitan region. Patients with prior history seizures/epilepsy were excluded from analysis. Results: A total 6044 strokes without seizure(s)...
Background and Purpose— Many advances were made in stroke prevention strategies during the 1990s, yet temporal trends incidence case-fatality have not been reported United States. Blacks a 2-fold higher risk of stroke; however, there are no data over time showing if any progress has reducing racial disparity incidence. The objective this study was to examine within large, biracial population 1990s. Methods— Within 1.3 million, all strokes ascertained at local hospitals using International...
Previous studies have shown poor public knowledge of stroke warning signs. The current education message adopted by the American Heart Association lists 5 signs ("suddens"). Another called FAST (face, arm, speech, time) could be easier to remember, but it does not contain as many symptoms. We sought assess percentage stroke/transient ischemic attack (TIA) patients identified both awareness messages examining presenting symptoms all stroke/TIA from a large, biracial population in 1999.Cases...
We previously reported increased incidence of ischemic stroke among both blacks and whites with diabetes mellitus, especially in those aged <55 years. With rising prevalence mellitus the past decade, we revisit impact on same population (≈1.3 million) 5 10 years later.
Little is known about the distribution of National Institutes Health Stroke Scale (NIHSS) scores from patients with ischemic stroke sampled population-based studies. We describe NIHSS in cases Cincinnati/Northern Kentucky Study.Within a biracial population 1.3 million, all strokes among area residents 2005 were ascertained by screening discharge records at local hospitals and outpatient clinics. A sampling scheme was developed to ascertain additional presenting physician offices nursing...
The publication of the European Cooperative Acute Stroke Study (ECASS III) expanded treatment time to thrombolysis for acute ischemic stroke from 3 4.5 hours symptom onset. impact window on rates has not been comprehensively evaluated in a population-based study.
We sought to build models that address questions of interest patients and families by predicting short- long-term mortality functional outcome after ischemic stroke, while allowing for risk restratification as comorbid events accumulate.A cohort 451 stroke subjects in 1999 were interviewed during hospitalization, at 3 months, approximately 4 years. Medical records from the acute hospitalization abstracted. All hospitalizations months poststroke reviewed ascertain medical psychiatric...
Delay in seeking medical attention after stroke symptom onset is the most important reason for low rates of thrombolytic use ischemic (IS) United States. This may be related to poor recognition symptoms, or lack awareness time-sensitive treatments. We describe public knowledge t-PA as a treatment IS, well changes over time warning signs (WS) and risk factors (RF).Survey respondents were drawn from our biracial population 1.3 million using random-digit dialing 1995, 2000, 2005 reflect age,...
Background and Purpose- Sex differences in stroke incidence over time were previously reported from the GCNKSS (Greater Cincinnati/Northern Kentucky Stroke Study). We aimed to determine whether these continued through 2015 they driven by particular age groups. Methods- Within population of 1.3 million, incident (first ever) strokes among residents ≥20 years ascertained at all local hospitals during 5 periods: July 1993 June 1994 calendar 1999, 2005, 2010, 2015. Out-of-hospital cases sampled....
Approximately 5% of strokes occur in adults aged 18 to 44 years. Substance abuse is a prevalent risk factor for stroke young adults. We sought identify trends substance detection among patients.
<h3>Objective:</h3> To characterize temporal trends in subarachnoid hemorrhage (SAH) incidence and outcomes over 5 time periods a large population-based stroke study the United States. <h3>Methods:</h3> All SAHs among residents of Greater Cincinnati/Northern Kentucky region at least 20 years age were identified verified via physician review distinct year-long between 1988 2010. We abstracted demographics, care patterns, outcomes, we compared case-fatality rates across periods....
Background and Purpose —The volume of ischemic stroke on CT scans has been studied in a standardized fashion acute therapy trials with median volumes between 10.5 to 55 cm 3 . The first-ever the population is not known. Methods first phase population-based Greater Cincinnati/Northern Kentucky Stroke Study identified all strokes occurring blacks greater Cincinnati region January June 1993. patients this study who had clinical were identified, was measured. Results —There 257 verified cases...
Antithrombotic medications (anticoagulants and antiplatelets) are often withheld in the periprocedural period after bleeding complications to limit risk of new or recurrent bleeding. These also stopped by patients for various reasons such as cost, side effects, unwillingness take medication.Patient records from population-based Greater Cincinnati/Northern Kentucky Stroke Study were reviewed identify cases ischemic stroke 2005 determine temporal association strokes with withdrawal...
Recent data suggest stroke incidence is decreasing over time, but it unknown whether in women and men to the same extent. Within our population of 1.3 million, all incident strokes among residents ≥20 years old were ascertained at hospitals during July 1993-June 1994 calendar 1999, 2005, 2010. A sampling scheme was used ascertain out-of-hospital cases. Sex-specific rates per 100,000 black white participants, age- race-adjusted, standardized 2000 US Census population. Trends time by sex...
Spasticity often leads to symptomatic and functional problems that can cause disability for stroke survivors. We studied whether spasticity has a negative impact on health-related quality of life (HRQoL). As part the Greater Cincinnati/Northern Kentucky Stroke Study (NCT00642213), 460 ischemic patients were interviewed during hospitalization then followed over time. HRQoL was measured by Physical Component Summary (PCS) Mental (MCS) scores Short Form-12 (SF-12), EuroQol-5 dimension (EQ-5D),...