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Article: Patient Characteristics Associated With Readmission to 3 Neurology Services at an Urban Academic Center.

Bondi, Steven / Yang, Dixon / Croll, Leah / Torres, Jose

2020 Volume 11, Issue 1, Page(s) 25–32

Abstract: Background and purpose: Hospital 30-day readmissions in patients with primary neurological problems are not well characterized. We sought to determine patient characteristics associated with readmission across 3 different inpatient neurology services at ...

Abstract	Background and purpose: Hospital 30-day readmissions in patients with primary neurological problems are not well characterized. We sought to determine patient characteristics associated with readmission across 3 different inpatient neurology services at New York University Langone Hospital. Methods: We retrospectively reviewed all 30-day readmissions from the General Neurology, Epilepsy, and Stroke services at NYULH Brooklyn and Manhattan campuses from 2016-2017 and compared them to a random sample of non-readmitted neurology patients. We used univariate analyses to compare demographics, clinical characteristics, disease specific metrics, and discharge factors of non-readmitted and readmitted groups and binomial logistic regression to examine specific variables with adjustment for confounders. Results: We included 284 patients with 30-day readmissions and 306 control patients without readmissions matched by discharge location and service. After adjusting for confounders, we found that the following factors were associated with increased readmission risk: a recent hospital encounter increased risk for all services, increased number of medications at discharge, intensive care unit stay, higher length of stay, and prior history of seizure for the General Neurology Service, increased number of medications at discharge for the Epilepsy Service, and active malignancy and higher discharge modified Rankin Scale score for the Stroke Service. Conclusion: This study identifies potential risk factors for readmission in patients across multiple neurology services. Further research is needed to establish whether these risk factors hold across multiple institutions.
Language	English
Publishing date	2020-09-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	2629083-2
ISSN	1941-8752 ; 1941-8744
ISSN (online)	1941-8752
ISSN	1941-8744
DOI	10.1177/1941874420953320
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Article ; Online: Epilepsy in nonhuman primates.

Croll, Leah / Szabo, Charles A / Abou-Madi, Noha / Devinsky, Orrin

Epilepsia

2019 Volume 60, Issue 8, Page(s) 1526–1538

Abstract: Objectives: Nonhuman primates (NHPs) are model organisms for understanding the pathophysiology and treatment of epilepsy in humans, while data from human patients informs the diagnosis and treatment of NHP with seizures and epilepsy. We reviewed the ... ...

Abstract	Objectives: Nonhuman primates (NHPs) are model organisms for understanding the pathophysiology and treatment of epilepsy in humans, while data from human patients informs the diagnosis and treatment of NHP with seizures and epilepsy. We reviewed the literature and surveyed veterinarians at zoos and NHP research centers to (a) better define the range of seizures and epilepsy in NHP, (b) understand how NHPs can inform our knowledge of the pathophysiology and treatment of epilepsy in humans, and (c) identify gaps of knowledge and develop more effective guidelines to treat seizures and epilepsy in NHP. Methods: We searched PrimateLit, PubMed, and Google Scholar for studies on experimental models of epilepsy in NHPs and on naturally occurring seizures and epilepsy in NHPs in captivity. In addition, we created a survey to assess methods to diagnose and treat epilepsy in NHPs. This survey was sent to 41 veterinarians at major international zoos and research facilities with NHP populations to study seizure phenomenology, diagnostic criteria for seizures and epilepsy, etiology, and antiseizure therapies in NHPs. Results: We summarize the data from experimental and natural models of epilepsy in NHPs and case reports of epilepsy of unknown origin in captive primates. In addition, we present survey data collected from veterinarians at eight zoos and one research facility. Experimental data from NHP epilepsy models is abundant, whereas data from primates who develop epilepsy in the wild or in zoos is very limited, constraining our ability to advance evidence-based medicine. Significance: Characterization of seizure or epilepsy models in NHPs will provide insights into mechanisms and new therapies that cannot be addressed by other animal models. NHP research will better inform species-specific diagnoses and outcomes.
MeSH term(s)	Animals ; Disease Models, Animal ; Epilepsy/physiopathology ; Epilepsy/therapy ; Epilepsy/veterinary ; Haplorhini ; Primate Diseases/physiopathology ; Primate Diseases/therapy ; Seizures/physiopathology ; Seizures/therapy ; Seizures/veterinary
Language	English
Publishing date	2019-06-17
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	216382-2
ISSN	1528-1167 ; 0013-9580
ISSN (online)	1528-1167
ISSN	0013-9580
DOI	10.1111/epi.16089
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Article ; Online: The psychosocial implications of COVID-19 for a neurology program in a pandemic epicenter.

Croll, Leah / Kurzweil, Arielle / Hasanaj, Lisena / Serrano, Liliana / Balcer, Laura J / Galetta, Steven L

Journal of the neurological sciences

2020 Volume 416, Page(s) 117034

Abstract: Objective: We discuss the psychosocial implications of the COVID-19 pandemic as self-reported by housestaff and faculty in the NYU Langone Health Department of Neurology, and summarize how our program is responding to these ongoing challenges.: ... ...

Abstract	Objective: We discuss the psychosocial implications of the COVID-19 pandemic as self-reported by housestaff and faculty in the NYU Langone Health Department of Neurology, and summarize how our program is responding to these ongoing challenges. Methods: During the period of May 1-4, 2020, we administered an anonymous electronic survey to all neurology faculty and housestaff to assess the potential psychosocial impacts of COVID-19. The survey also addressed how our institution and department are responding to these challenges. This report outlines the psychosocial concerns of neurology faculty and housestaff and the multifaceted support services that our department and institution are offering in response. Faculty and housestaff cohorts were compared with regard to frequencies of binary responses (yes/ no) using the Fisher's exact test. Results: Among 130 total survey respondents (91/191 faculty [48%] and 37/62 housestaff [60%]), substantial proportions of both groups self-reported having increased fear (79%), anxiety (83%) and depression (38%) during the COVID-19 pandemic. These proportions were not significantly different between the faculty and housestaff groups. Most respondents reported that the institution had provided adequate counseling and support services (91%) and that the department had rendered adequate emotional support (92%). Participants offered helpful suggestions regarding additional resources that would be helpful during the COVID-19 pandemic. Conclusion: COVID-19 has affected the lives and minds of faculty and housestaff in our neurology department at the epicenter of the pandemic. Efforts to support these providers during this evolving crisis are imperative for promoting the resilience necessary to care for our patients and colleagues.
MeSH term(s)	Anxiety/psychology ; COVID-19/psychology ; Humans ; Internship and Residency ; Neurology ; New York City ; Pandemics
Keywords	covid19
Language	English
Publishing date	2020-07-14
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	80160-4
ISSN	1878-5883 ; 0022-510X ; 0374-8642
ISSN (online)	1878-5883
ISSN	0022-510X ; 0374-8642
DOI	10.1016/j.jns.2020.117034
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Article ; Online: In Response to: "Single Versus Multiple Hyperbaric Sessions for Carbon Monoxide Poisoning in a Murine Model".

Croll, Leah S / Wightman, Rachel S / Hoffman, Robert S

Journal of medical toxicology : official journal of the American College of Medical Toxicology

2016 Volume 13, Issue 1, Page(s) 128

MeSH term(s)	Animals ; Carbon Monoxide Poisoning ; Disease Models, Animal ; Hyperbaric Oxygenation ; Mice
Language	English
Publishing date	2016-10-04
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	2435016-3
ISSN	1937-6995 ; 1556-9039
ISSN (online)	1937-6995
ISSN	1556-9039
DOI	10.1007/s13181-016-0589-x
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Article ; Online: The psychosocial implications of COVID-19 for a neurology program in a pandemic epicenter

Croll, Leah / Kurzweil, Arielle / Hasanaj, Lisena / Serrano, Liliana / Balcer, Laura J. / Galetta, Steven L.

Journal of the Neurological Sciences

2020 Volume 416, Page(s) 117034

Keywords	Neurology ; Clinical Neurology ; covid19
Language	English
Publisher	Elsevier BV
Publishing country	us
Document type	Article ; Online
ZDB-ID	80160-4
ISSN	1878-5883 ; 0022-510X ; 0374-8642
ISSN (online)	1878-5883
ISSN	0022-510X ; 0374-8642
DOI	10.1016/j.jns.2020.117034
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Article ; Online: Markers of infection and inflammation are associated with post-thrombectomy mortality in acute stroke.

Irvine, Hannah / Krieger, Penina / Melmed, Kara R / Torres, Jose / Croll, Leah / Zhao, Amanda / Lord, Aaron / Ishida, Koto / Frontera, Jennifer / Lewis, Ariane

Clinical neurology and neurosurgery

2022 Volume 222, Page(s) 107467

Abstract: Objective: We explored the relationship between markers of infection and inflammation and mortality in patients with acute ischemic stroke who underwent thrombectomy.: Methods: We performed retrospective chart review of stroke patients who underwent ... ...

Abstract	Objective: We explored the relationship between markers of infection and inflammation and mortality in patients with acute ischemic stroke who underwent thrombectomy. Methods: We performed retrospective chart review of stroke patients who underwent thrombectomy at two tertiary academic centers between December 2018 and November 2020. Associations between discharge mortality, WBC count, neutrophil percentage, fever, culture data, and antibiotic treatment were analyzed using the Wilcoxon rank sum test, Student's t-test, and Fisher's exact test. Independent predictors of mortality were identified with multivariable analysis. Analyses were repeated excluding COVID-positive patients. Results: Of 248 patients who underwent thrombectomy, 41 (17 %) died prior to discharge. Mortality was associated with admission WBC count (11 [8-14] vs. 9 [7-12], p = 0.0093), admission neutrophil percentage (78 % ± 11 vs. 71 % ± 14, p = 0.0003), peak WBC count (17 [13-22] vs. 12 [9-15], p < 0.0001), fever (71 % vs. 27 %, p < 0.0001), positive culture (44 % vs. 15 %, p < 0.0001), and days treated with antibiotics (3 [1-7] vs. 1 [0-4], p < 0.0001). After controlling for age, admission NIHSS and post-thrombectomy ASPECTS score, mortality was associated with admission WBC count (OR 13, CI 1.32-142, p = 0.027), neutrophil percentage (OR 1.03, CI 1.0-1.07, p = 0.045), peak WBC count (OR 301, CI 24-5008, p < 0.0001), fever (OR 24.2, CI 1.77-332, p < 0.0001), and positive cultures (OR 4.24, CI 1.87-9.62, p = 0.0006). After excluding COVID-positive patients (n = 14), peak WBC count, fever and positive culture remained independent predictors of mortality. Conclusion: Markers of infection and inflammation are associated with discharge mortality after thrombectomy. Further study is warranted to investigate the causal relationship of these markers with clinical outcome.
MeSH term(s)	Humans ; Retrospective Studies ; Ischemic Stroke ; Treatment Outcome ; COVID-19 ; Thrombectomy ; Stroke/complications ; Biomarkers ; Inflammation ; Anti-Bacterial Agents ; Brain Ischemia/complications
Chemical Substances	Biomarkers ; Anti-Bacterial Agents
Language	English
Publishing date	2022-10-07
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	193107-6
ISSN	1872-6968 ; 0303-8467
ISSN (online)	1872-6968
ISSN	0303-8467
DOI	10.1016/j.clineuro.2022.107467
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Article ; Online: Pre-admission antithrombotic use is associated with 3-month mRS score after thrombectomy for acute ischemic stroke.

Krieger, Penina / Melmed, Kara R / Torres, Jose / Zhao, Amanda / Croll, Leah / Irvine, Hannah / Lord, Aaron / Ishida, Koto / Frontera, Jennifer / Lewis, Ariane

Journal of thrombosis and thrombolysis

2022 Volume 54, Issue 2, Page(s) 350–359

Abstract: In patients who undergo thrombectomy for acute ischemic stroke, the relationship between pre-admission antithrombotic (anticoagulation or antiplatelet) use and both radiographic and functional outcome is not well understood. We sought to explore the ... ...

Abstract	In patients who undergo thrombectomy for acute ischemic stroke, the relationship between pre-admission antithrombotic (anticoagulation or antiplatelet) use and both radiographic and functional outcome is not well understood. We sought to explore the relationship between pre-admission antithrombotic use in patients who underwent thrombectomy for acute ischemic stroke at two medical centers in New York City between December 2018 and November 2020. Analyses were performed using analysis of variance and Pearson's chi-squared tests. Of 234 patients in the analysis cohort, 65 (28%) were on anticoagulation, 64 (27%) were on antiplatelet, and 105 (45%) with no antithrombotic use pre-admission. 3-month Modified Rankin Scale (mRS) score of 3-6 was associated with pre-admission antithrombotic use (71% anticoagulation vs. 77% antiplatelet vs. 56% no antithrombotic, p = 0.04). There was no relationship between pre-admission antithrombotic use and Thrombolysis in Cerebral Iinfarction (TICI) score, post-procedure Alberta Stroke Program Early CT Score (ASPECTS) score, rate of hemorrhagic conversion, length of hospital admission, discharge NIH Stroke Scale (NIHSS), discharge mRS score, or mortality. When initial NIHSS score, post-procedure ASPECTS score, and age at admission were included in multivariate analysis, pre-admission antithrombotic use was still significantly associated with a 3-month mRS score of 3-6 (OR 2.36, 95% CI 1.03-5.54, p = 0.04). In this cohort of patients with acute ischemic stroke who underwent thrombectomy, pre-admission antithrombotic use was associated with 3-month mRS score, but no other measures of radiographic or functional outcome. Further research is needed on the relationship between use of specific anticoagulation or antiplatelet agents and outcome after acute ischemic stroke, but moreover, improve stroke prevention.
MeSH term(s)	Anticoagulants ; Brain Ischemia/drug therapy ; Brain Ischemia/etiology ; Brain Ischemia/surgery ; Humans ; Ischemic Stroke ; Retrospective Studies ; Stents ; Stroke/drug therapy ; Stroke/etiology ; Stroke/surgery ; Thrombectomy/methods ; Treatment Outcome
Chemical Substances	Anticoagulants
Language	English
Publishing date	2022-07-21
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1230645-9
ISSN	1573-742X ; 0929-5305
ISSN (online)	1573-742X
ISSN	0929-5305
DOI	10.1007/s11239-022-02680-y
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Article ; Online: Tachycardia is associated with mortality and functional outcome after thrombectomy for acute ischemic stroke.

Krieger, Penina / Zhao, Amanda / Croll, Leah / Irvine, Hannah / Torres, Jose / Melmed, Kara R / Lord, Aaron / Ishida, Koto / Frontera, Jennifer / Lewis, Ariane

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association

2022 Volume 31, Issue 6, Page(s) 106450

Abstract: Background: The relationship between cardiac function and mortality after thrombectomy for acute ischemic stroke is not well elucidated.: Methods: We analyzed the relationship between cardiac function and mortality prior to discharge in a cohort of ... ...

Abstract	Background: The relationship between cardiac function and mortality after thrombectomy for acute ischemic stroke is not well elucidated. Methods: We analyzed the relationship between cardiac function and mortality prior to discharge in a cohort of patients who underwent thrombectomy for acute ischemic stroke at two large medical centers in New York City between December 2018 and November 2020. All analyses were performed using Welch's two sample t-test and logistic regression accounting for age, initial NIHSS and post-procedure ASPECTS score, where OR is for each unit increase in the respective variables. Results: Of 248 patients, 41 (16.5%) died prior to discharge. Mortality was significantly associated with higher initial heart rate (HR; 89 ± 19 bpm vs 80 ± 18 bpm, p = 0.004) and higher maximum HR over entire admission (137 ± 26 bpm vs 114 ± 25 bpm, p < 0.001). Mortality was also associated with presence of NSTEMI/STEMI (63% vs 29%, p < 0.001). When age, initial NIHSS score, and post-procedure ASPECTS score were included in multivariate analysis, there was still a significant relationship between mortality and initial HR (OR 1.03, 95% CI 1.01- 1.05, p = 0.02), highest HR over the entire admission (OR 1.03, 95% CI 1.02-1.05, p < 0.001), and presence of NSTEMI/STEMI (OR 3.76, 95% CI 1.66-8.87, p = 0.002). Conclusions: Tachycardia is associated with mortality in patients who undergo thrombectomy. Further investigation is needed to determine whether this risk is modifiable.
MeSH term(s)	Humans ; Ischemic Stroke ; Non-ST Elevated Myocardial Infarction ; Retrospective Studies ; ST Elevation Myocardial Infarction/complications ; Stroke/complications ; Stroke/diagnosis ; Stroke/therapy ; Tachycardia/complications ; Thrombectomy ; Treatment Outcome
Language	English
Publishing date	2022-04-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	1131675-5
ISSN	1532-8511 ; 1052-3057
ISSN (online)	1532-8511
ISSN	1052-3057
DOI	10.1016/j.jstrokecerebrovasdis.2022.106450
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Article: The psychosocial implications of COVID-19 for a neurology program in a pandemic epicenter

Croll, Leah / Kurzweil, Arielle / Hasanaj, Lisena / Serrano, Liliana / Balcer, Laura J / Galetta, Steven L

J Neurol Sci

Abstract: OBJECTIVE: We discuss the psychosocial implications of the COVID-19 pandemic as self-reported by housestaff and faculty in the NYU Langone Health Department of Neurology, and summarize how our program is responding to these ongoing challenges. METHODS: ... ...

Abstract	OBJECTIVE: We discuss the psychosocial implications of the COVID-19 pandemic as self-reported by housestaff and faculty in the NYU Langone Health Department of Neurology, and summarize how our program is responding to these ongoing challenges. METHODS: During the period of May 1-4, 2020, we administered an anonymous electronic survey to all neurology faculty and housestaff to assess the potential psychosocial impacts of COVID-19. The survey also addressed how our institution and department are responding to these challenges. This report outlines the psychosocial concerns of neurology faculty and housestaff and the multifaceted support services that our department and institution are offering in response. Faculty and housestaff cohorts were compared with regard to frequencies of binary responses (yes/ no) using the Fisher's exact test. RESULTS: Among 130 total survey respondents (91/191 faculty [48%] and 37/62 housestaff [60%]), substantial proportions of both groups self-reported having increased fear (79%), anxiety (83%) and depression (38%) during the COVID-19 pandemic. These proportions were not significantly different between the faculty and housestaff groups. Most respondents reported that the institution had provided adequate counseling and support services (91%) and that the department had rendered adequate emotional support (92%). Participants offered helpful suggestions regarding additional resources that would be helpful during the COVID-19 pandemic. CONCLUSION: COVID-19 has affected the lives and minds of faculty and housestaff in our neurology department at the epicenter of the pandemic. Efforts to support these providers during this evolving crisis are imperative for promoting the resilience necessary to care for our patients and colleagues.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #641179
Database	COVID19

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