Cohort profile: Thrombolysis in Ischemic Stroke Patients (TRISP): a multicentre research collaboration

Abstract

PurposeThe ThRombolysis in Ischemic Stroke Patients (TRISP) collaboration aims to address clinically relevant questions about safety and outcomes of intravenous thrombolysis (IVT) and endovascular thrombectomy. The findings can provide observational information on treatment of patients derived from everyday clinical practice.ParticipantsTRISP is an open, investigator-driven collaborative research initiative of European stroke centres with expertise in treatment with revascularisation therapies and maintenance of hospital-based registries. All participating centres made a commitment to prospectively collect data on consecutive patients with stroke treated with IVT using standardised definitions of variables and outcomes, to assure accuracy and completeness of the data and to adapt their local databases to answer novel research questions.Findings to dateCurrently, TRISP comprises 18 centres and registers >10 000 IVT-treated patients. Prior TRISP projects provided evidence on the safety and functional outcome in relevant subgroups of patients who were excluded, under-represented or not specifically addressed in randomised controlled trials (ie, pre-existing disability, cervical artery dissections, stroke mimics, prior statin use), demonstrated deficits in organisation of acute stroke care (ie, IVT during non-working hours, effects of onset-to-door time on onset-to-needle time), evaluated the association between laboratory findings on outcome after IVT and served to develop risk estimation tools for prediction of haemorrhagic complications and functional outcome after IVT.Future plansFurther TRISP projects to increase knowledge of the effect and safety of revascularisation therapies in acute stroke are ongoing. TRISP welcomes participation and project proposals of further centres fulfilling the outlined requirements. In the future, TRISP will be extended to include patients undergoing endovascular thrombectomy.

Intravenous thrombolysis for suspected ischemic stroke with seizure at onset

“…For this study, we pooled data on prospectively registered, consecutive patients with suspected acute ischemic stroke treated with IVT alone or IVT followed by endovascular treatment (EVT) from 9 European stroke centers within the ThRombolysis in Ischemic Stroke Patients (TRISP) Collaboration. The detailed methodology of TRISP has been previously published . In short, data were collected locally at each TRISP center using a standardized form with predefined parameters and were pooled and analyzed at the TRISP center in Basel, Switzerland.…”

“…The following baseline TRISP parameters were used: age, sex, vascular risk factors according to predefined criteria, prior stroke, prior antithrombotic treatment (antiplatelets and/or anticoagulants), prior functional dependence (defined as prestroke modified Rankin Scale [mRS] ≥ 3), National Institutes of Health Stroke Scale (NIHSS) score on admission, estimated glomerular filtration rate (eGFR) according to the Chronic Kidney Disease Epidemiology Collaboration formula and glucose on admission, onset‐to‐treatment time, treatment with IVT alone or IVT followed by EVT, presence or absence of early hypodensity on initial computed tomography (CT) scan (as in prior research, added post hoc), and final diagnosis of ischemic stroke or stroke mimic. Stroke mimics were labeled as such when any final diagnosis other than stroke was made by the patients’ treating physicians after exclusion of an ischemic cause of the stroke‐like symptoms based on clinical examinations and neuroimaging findings, as previously described…”

“…Outcome measures were: (1) symptomatic intracranial hemorrhage (sICH), according to the European Cooperative Acute Stroke Study II (ECASS‐II) definition, (2) all‐cause mortality at 3 months, and (3) functional outcome on the mRS at 3 months. As previously described, the 3‐month outcomes were assessed during outpatient visits, with postal questionnaires, or telephone calls with patients, patients’ relatives, and/or general practitioners as applicable.…”

“…16 In short, data were collected locally at each TRISP center using a standardized form with predefined parameters and were pooled and analyzed at the TRISP center in Basel, Switzerland. The detailed methodology of TRISP has been previously published.…”

“…The detailed methodology of TRISP has been previously published. 16 In short, data were collected locally at each TRISP center using a standardized form with predefined parameters and were pooled and analyzed at the TRISP center in Basel, Switzerland. This study had been submitted to the ethics committee in the leading center Basel.…”