title: Analyses of the Turkish National Intravenous Thrombolysis Registry.
abstract: BACKGROUND
  The relatively late approval of use of recombinant tissue plasminogen activator (rt-PA) for acute ischemic stroke in Turkey has resulted in obvious underuse of this treatment. Here we present the analyses of the nationwide registry, which was created to prompt wider use of intravenous thrombolysis, as well as to monitor safe implementation of the treatment in our country.
  
  
  METHODS
  Patients were registered prospectively in our database between 2006 and 2013. Admission and 24-hour National Institutes of Health Stroke Scale and 3-month modified Rankin Scale scores were recorded. A "high-volume center" was defined as a center treating 10 or more patients with rt-PA per year.
  
  
  RESULTS
  A total of 1133 patients were enrolled into the registry by 38 centers in 18 cities. A nearly 4-fold increase in the study population and in the number of participating centers was observed over the 6 years of the study. The mean baseline NIHSS score was 14.5 ± 5.7, and the prevalence of symptomatic hemorrhage was 4.9%. Mortality at 3 months decreased from 22% to 11% in the 6 years of enrollment, and 65% of cases were functionally independent. Age older than 70 years, an NIHSS score higher than 14 upon hospital admission, and intracranial hemorrhage were independently associated with mortality, and being treated in a high-volume center was related to good outcome.
  
  
  CONCLUSIONS
  We observed a decreasing trend in mortality and an acceptable prevalence of symptomatic hemorrhage over 6 years with continuous addition of new centers to the registry. The first results of this prospective study are encouraging and will stimulate our efforts at increasing the use of intravenous thrombolysis in Turkey.
authors: Department of Neurology, University of Dokuz Eylul, Izmir, Turkey. Electronic address: kursad.kutluk@gmail.com.
authors: Kursad
authors: K
authors: Kutluk
authors: Department of Neurology, University of Acibadem, Istanbul, Turkey.
authors: Dilaver
authors: D
authors: Kaya
authors: Department of Neurology, University of Bahcesehir, Istanbul, Turkey.
authors: Nazire
authors: N
authors: Afsar
authors: Department of Neurology, University of Hacettepe, Ankara, Turkey.
authors: Ethem Murat
authors: EM
authors: Arsava
authors: Department of Neurology, University of Dokuz Eylul, Izmir, Turkey.
authors: Vesile
authors: V
authors: Ozturk
authors: Department of Neurology, University of Osman Gazi, Eskisehir, Turkey.
authors: Nevzat
authors: N
authors: Uzuner
authors: Department of Neurology, University of Gaziantep, Gaziantep, Turkey.
authors: Semih
authors: S
authors: Giray
authors: Department of Neurology, University of Hacettepe, Ankara, Turkey.
authors: Mehmet Akif
authors: MA
authors: Topcuoglu
authors: Department of Neurology, University of Ondokuz Mayis, Samsun, Turkey.
authors: Levent
authors: L
authors: Gungor
authors: Department of Neurology, University of Ege, Izmir, Turkey.
authors: Hadiye
authors: H
authors: Sirin
authors: Department of Neurology, University of Dokuz Eylul, Izmir, Turkey.
authors: Erdem
authors: E
authors: Yaka
authors: Department of Neurology, University of Osman Gazi, Eskisehir, Turkey.
authors: Ozcan
authors: O
authors: Ozdemir
authors: Department of Neurology, University of Hacettepe, Ankara, Turkey.
authors: Turgay
authors: T
authors: Dalkara
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D061847:Hospitals, High-Volume; D061846:Hospitals, Low-Volume; D006801:Humans; D007262:Infusions, Intravenous; D020300:Intracranial Hemorrhages / Q000139:chemically induced / Q000401:mortality; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000639:trends; D015995:Prevalence; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000008:administration & dosage; D012042:Registries; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D015912:Thrombolytic Therapy / Q000009:adverse effects / Q000401:mortality / Q000639:trends; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology
chemical_list: D005343:Fibrinolytic Agents; D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator
keywords: Intravenous thrombolysis; acute ischemic stroke; acute stroke treatment; thrombolytic therapy