Thrombolytic Therapy for Stroke in Turkey: Meta-analysis of Published Case Series

Mustafa Çetiner; Ethem Murat Arsava; Mehmet Akif Topçuoğlu

doi:10.4274/tnd.2020.55476

Mustafa Çetiner¹, Ethem Murat Arsava², Mehmet Akif Topçuoğlu²

¹Kutahya University of Health Sciences Faculty of Medicine, Department of Neurology, Kutahya, Turkey
²Hacettepe University Faculty of Medicine, Department of Neurology, Ankara, Turkey

Keywords: tPA, alteplase, plasminogen, stroke unit, intracerebral hemorrhage, acute stroke

Abstract

Objective: To evaluate the results of published case series originating from Turkey, which may be useful for system planning and institutional goal setting in the clinical practice of intravenous tissue plasminogen activator therapy for acute stroke.

Materials and Methods: A meta-analysis of case series, published in the last 10 years, from Turkish hospitals / institutions about intravenous thrombolytic therapy in acute stroke was performed. Weighted averages and 95% confidence intervals, Q and I2 values were calculated using the standard method based on random-effect model.

Results: A total of 2349 patients (52% female, mean age 65±12 years) in 21 articles were included. The mean symptom-to-needle time was 111±16 minutes; pre-thrombolysis average NIH stroke score was 13.8±4.2; mean good prognosis (modified Rankin’s score, 2 or lower) rate was 59.6%; mortality rate was 16.5%, and symptomatic thrombolytic-related intracerebral bleeding was 5.6%. There was no large grade heterogeneity among the enrolled series.

Conclusion: Results of published Turkey-based thrombolysis case series meet the current world standards. The values produced herein can be used as standards for center-based quality metrics.