A5053306830- Acute Ischemic Stroke Management
- Stroke Rehabilitation and Recovery
- Venous Thromboembolism Diagnosis and Management
- Traumatic Brain Injury and Neurovascular Disturbances
- Cardiovascular Health and Risk Factors
- Peripheral Artery Disease Management
- COVID-19 and healthcare impacts
- Antiplatelet Therapy and Cardiovascular Diseases
- Cerebrovascular and Carotid Artery Diseases
- Intracerebral and Subarachnoid Hemorrhage Research
- Healthcare Systems and Public Health
- Nursing Diagnosis and Documentation
- Dementia and Cognitive Impairment Research
- Neurosurgical Procedures and Complications
- Trauma and Emergency Care Studies
- Global Health Care Issues
- Insurance, Mortality, Demography, Risk Management
- Heart Failure Treatment and Management
- Health Sciences Research and Education
- Hip and Femur Fractures
- Health disparities and outcomes
- Neurological Disorders and Treatments
- Chronic Disease Management Strategies
- Blood Pressure and Hypertension Studies
- Geriatric Care and Nursing Homes
American Heart Association
2017-2024
University of Miami
2017-2023
University of South Florida
2017-2023
Baptist Health South Florida
2023
Florida International University
2017-2023
Jackson Memorial Hospital
2022
Columbia University
2022
National Institute of Diabetes and Digestive and Kidney Diseases
2017
Asperger/Autism Network
2017
University of Minnesota
2011
Racial-ethnic disparities in acute stroke care can contribute to inequality outcomes. We examined race-ethnic performance metrics a voluntary registry among Florida and Puerto Rico Get With the Guidelines-Stroke hospitals.Seventy-five sites Stroke Registry (66 9 Rico) recorded 58 864 ischemic cases (2010-2014). Logistic regression models racial-ethnic differences measures defect-free (intravenous tissue plasminogen activator treatment, in-hospital antithrombotic therapy, deep vein thrombosis...
Impaired level of consciousness (LOC) on presentation at hospital admission in patients with intracerebral hemorrhage (ICH) may affect outcomes and the decision to withhold or withdraw life-sustaining treatment (WOLST).Patients ICH were included across 121 Florida hospitals participating Stroke Registry from 2010 2019. We studied effect LOC in-hospital mortality (primary outcome), WOLST, ambulation status discharge, length stay, discharge disposition.Among 37 613 cases (mean age 71, 46%...
Early consciousness disorder (ECD) after acute ischemic stroke (AIS) is understudied. ECD may influence outcomes and the decision to withhold or withdraw life-sustaining treatment.We studied patients with AIS from 2010 2019 across 122 hospitals participating in Florida Stroke Registry. We effect of on in-hospital mortality, withholding withdrawal treatment (WLST), ambulation status discharge, hospital length stay, discharge disposition.Of 238,989 AIS, 32,861 (14%) had at presentation....
Background and Purpose— In the United States, about half of acute ischemic stroke patients treated with tPA (tissue-type plasminogen activator) receive treatment within 60 minutes hospital arrival. We aimed to determine proportion receiving (door-to-needle time [DTNT] ≤60) 45 (DTNT ≤45) arrival by race/ethnicity sex identify temporal trends in DTNT ≤60 ≤45. Methods— Among 65 654 admissions National Institute Neurological Disorders Stroke-funded FL-PR CReSD study (Florida-Puerto Rico...
Short-term dual antiplatelet therapy (DAPT) reduces early stroke recurrence after mild noncardioembolic ischemic (NCIS). We aim to evaluate temporal trends and determinants of DAPT prescription NCIS in the Florida Stroke Registry, a statewide registry across Get With The Guidelines-Stroke participating hospitals.
Background Less than 40% of acute stroke patients have computed tomography (CT) imaging performed within 25 minutes hospital arrival. We aimed to examine the race-ethnic and sex differences in door-to-CT (DTCT) ≤25 FSR (Florida Stroke Registry). Methods Results Data were collected from 2010 2018 for 63 265 with ischemic secondary analysis was on 15 877 intravenous tissue plasminogen activator-treated stroke. Generalized estimating equation models used determine predictors DTCT ≤25. achieved...
To develop evidence-based standardized care plans (EB-SCP) for use internationally to improve home practice and population health.A clinical-expert scholarly method consisting of clinical experts recruitment, identification health concerns, literature reviews, development EB-SCPs using the Omaha System, a public comment period, revisions consensus.Clinical from Canada, Netherlands, New Zealand, United States participated in project, together with University Minnesota School Nursing graduate...
The Florida Stroke Act, signed into law in 2004, set criteria for Comprehensive Centers (CSC). For a time period, hospitals were permitted to either receive national certification (NC) or could self-attest (SA) as fulfilling CSC criteria. aim of this project was evaluate the quality ischemic stroke care NC versus SA centers Florida, using well-known, guideline-driven outcome metrics.A total 37 CSCs (74% CSCs) Registry from January 2013 through December 2018 analyzed, including 19 and 18 (13...
OBJECTIVES: Temporal trends and factors associated with the withdrawal of life-sustaining therapy (WLST) after acute stroke are not well determined. DESIGN: Observational study (2008–2021). SETTING: Florida Stroke Registry (152 hospitals). PATIENTS: Acute ischemic (AIS), intracerebral hemorrhage (ICH), subarachnoid (SAH) patients. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Importance plots were performed to generate most predictive WLST. Area under curve (AUC) for receiver operating...
Analysis of mortality estimates and adjusted census data showed that men aged 70 to 79 married younger women tended live longer than older women. The standard ratio for 50-year-old husbands with wives was 90, whereas it 112 wives. For 70-year-old the comparable values were 80 133. Thus risk associated marriage a woman clearly less an woman. Two possible explanations advanced this relationship: (a) premarital selection factors may be related longevity, (b) psychological, physiological, or...
Background Hospital readmission is an important indicator of poor transition care post-stroke. Data on characteristics patients at highest risk for limited and necessary to inform effective interventions. The goal identify factors hospital discharge that predict 30-day in the Florida Stroke Registry (FSR). Methods study population included 45,877 discharged home or rehabilitation with ischemic stroke intracerebral hemorrhage FSR between 2017 2019. a voluntary statewide registry from 167...
Introduction: Short-term dual antiplatelet therapy (DAPT) lowers the risk of early stroke recurrence after mild non-cardioembolic ischemic (NCIS) and high-risk transient attack. However, DAPT benefit in moderate-to-severe NCIS is unknown. We sought to investigate time-trends determinants prescription Florida Stroke Registry (FSR). Methods: Within 168 FSR-participating hospitals, between January 2010 September 2022, we analyzed patients with NIHSS score >3, without other indication(s) for...
Introduction: The outcomes of endovascular thrombectomy (EVT) in SARS-CoV2 positive patients with acute ischemic stroke (AIS) are not well studied. In the large Florida Stroke Registry we compared hospital and discharge target vessel occlusions treated endovascularly versus without a infection status during their hospitalization. Methods: Data from Get With Guidelines-Stroke hospitals participating March 2020 to December 2022 were reviewed. EVT coding for testing stay categorized into or...
This paper looks at the development of logistic regression models to predict readmissions for medical patients on their initial admission hospital. The design our study was a retrospective analysis large dataset drawn from range secondary sources - medical, nursing, therapy and social care records. Three northern hospitals related community health districts organizations in UK participated. Records 1,192 discharged wards during period April 1992-March 1995 were analysed. Readmission within...
Objective: To identify race/ethnicity differences for in-hospital mortality and disability at discharge after acute ischemic stroke (AIS) in patients admitted to Florida hospitals participating the Collaboration Reduce Stroke Disparities. (CReSD). Background: Studies suggest care associated with describe a higher rate minority patients. We sought investigate race-ethnic disparities stroke. Design/Methods: In-hospital was analyzed 75,077 AIS cases from 69 FL AHA Get With Guidelines-Stroke...
Background: The coronavirus 2019 (COVID-19) pandemic has affected all aspects of stroke care delivery and resource allocation. We sought to study this effect utilizing the Florida Stroke Registry (FSR), which collects data from hospitals in large metropolitan cities small communities, each facing peaks at different timepoints within various healthcare system organizations. Methods: From March 2021, FSR identified 82,899 patients with final diagnosis ischemic TIA. metrics were compared...
Introduction: The decision to withhold or withdraw life-sustaining therapy (WLST) is common after acute stroke. Factors that may influence the are not well determined. We aimed investigate factors associated with WLST in hospitalized stroke patients. Methods: Patients ischemic (AIS), intracerebral hemorrhage (ICH), and subarachnoid (SAH) were included across 152 Florida hospitals participating prospective Stroke Registry from 2008-2021. Importance plots performed generate predictive WLST....
Stroke is a global public health burden, and therefore it critical to identify modifiable risk factors reduce stroke incidence improve outcomes. Depression such factor; however, the association between preexisting depression outcomes, as independent ambulation, not well studied, especially among racial-ethnic minority groups. To address this gap in literature, effects of on ambulatory status at hospital discharge after were evaluated individuals participating racially ethnically diverse...
Introduction: Primary stroke center (PSC) and comprehensive (CSC) designation in Florida aims to improve delivery of care outcomes for patients. In line with the goals NINDS funded Florida-Puerto Rico Collaboration Reduce Stroke Disparities (FL-PR CReSD) Study, we sought compare ischemic performance metrics by participating hospitals. Methods: We analyzed 74,623 cases acute from 26 CSC 40 PSC January 2010-April 2016. described patient demographics, comorbidities Get With The...
Aim: To describe hypertension prevalence (HTN) in a race diverse stroke registry and investigate associated presentation patients admitted for acute ischemic (AIS) hemorrhagic Florida hospitals participating the Collaboration to Reduce Stroke Disparities (CReSD). Background: HTN affects about 30% of U.S. adults this doubles among survivors. is major risk factor incident stoke recurrent stroke. Quantifying survivors important guide secondary prevention. Methods: 121,333 cases were analyzed...
Background: As key components of the AHA Life’s Simple 7 campaign, lifestyle modifications play an integral role in prevention vascular disease. Little is known about prevalence modification counseling patients with acute ischemic stroke (AIS). We sought to investigate disparities delivery interventions AIS large NINDS-funded FL-PR CReSD Registry Get With The Guidelines-Stroke (GWTG-S) data. Methods: GWTG-S collects data on provision several including exercise/weight loss, Therapeutic...
Background and Purpose: Endovascular thrombectomy improves functional outcome in select ischemic stroke patients. In the NINDS-funded CReSD Registry we sought to determine clinical, hospital regional characteristics associated with use of this therapy patients presenting acute stroke. Methods: Ischemic within 24 hours onset were prospectively included from 82 sites Florida Puerto Rico January 2010 April 2016. Independent predictors endovascular evaluated using multivariable logistic...
Background: Among stroke survivors, worse functional outcomes have been reported in race/ethnic minority groups. Race/ethnic differences post-stroke independent ambulation may be evident early and largely influenced by age. Independent is defined as the ability to walk without supervision or assistance from another person. Discharge status implications for long term rehabilitation after stroke. We sought determine impact of age on discharge large NINDS-funded FL-PR CReSD Registry Get With...