Article Figures & Data
Figures
- Figure 1
- A PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow chart was employed to demonstrate the study selection workflow. END, early neurological deterioration.
- Figure 2
- Random effects A) model for the incidence of END in the 16 included studies; B) estimation of the number of studies on age missing using the scissors compensation method; C) estimation of the number of studies on sex missing using the scissors compensation method; D) estimation of the number of studies on antiplatelets missing using the scissors compensation method.
- Figure 1
- Supplementary Forest plot of A) Age; B) Gender (male); C) BMI; D) current smokers; E) Current drinkers; F) Hypertension; G) Diabetes mellitus; H) Hyperlipidemia. BMI - Body mass index. The solid squares represent the weighted mean differences (WMD)/the risk ratios (RRs), the horizontal lines show the 95% confidence intervals (CIs), and the diamond indicated the pooled effect size.
- Figure 2
- Supplementary Forest plot of A) Atrial fbrillation; B) Previous stroke; C) Antihypertensives; D) Antidiabetic; E) Antiplatelets; F) NIHSS on admission; G) Glycemia; H) WBC. NIHSS, National Institutes of Health Stroke Scale. WBC - white blood cell count.
- Figure 3
- Supplementary Forest plot of A) SBP; B) DBP; C) DNT; D) OTT; E) TC; F) TG; G) LDL. SBP - systolic blood pressure; DBP - diastolic blood pressure; DNT - door-to-needle time; OTT - onset-to-treatment time; TC - cholesterol; TG - triglyceride; LDL - low density laipoprotein.
- Figure 4
- Supplementary Forest plot of TOAST classification. A) LAA; B) SAO; C) CE; D) Other. TOAST, Trial of Org 10,172 in Acute Stroke Treatment. LAA - large artery atherosclerosis; SAO - small-artery occlusion; CE - cardio embolism; Other, stroke of undetermined.
- Figure 3
- Sensitivity analysis, A) age; B) glycemia; C) WBC; D) LAA.
Tables
No Source(Author/Year/Country) Designs Setting Sample size,No. Total END Non-END 1 Boulenoir et al14 2020, France Retrospective Multicenter 74 22 52 2 Che et al15 2020, China Retrospective Multicenter 1107 81 1026 3 Huang et al16 2018, China Retrospective Single center 272 END(Identified causes) 14
Unexplained END 15243 4 Tanaka et al17 2020, Japan Retrospective Single center 744 ENDh 22
ENDi 57665 5 Li et al18 2019, China Retrospective Single center 139 25 114 6 Li et al19 2021, China Retrospective Single center 118 28 90 7 Liu et al20 2021, China Retrospective Single center 212 71 141 8 Mori et al21 2012, Japan Retrospective Multicenter 566 56 510 9 Yu et al10 2020,United Kingdom Retrospective Multicenter 50726 3415 47311 10 Seners et al22 2021, France Retrospective Multicenter 729 ENDh 8
ENDi 88633 11 Seners et al23 2014, France Retrospective Single center 309 END(Identified causes) 10
Unexplained END 23276 12 Seners et al24 2017, France Retrospective Single center 120 22 98 13 Shah et al5 2022, USA Retrospective Multicenter 1238 91 1147 14 Simonsen et al25 2016, Denmark Prospective Single center 569 ENDh 7
ENDi 26536 15 Wang et al26 2022, China Retrospective Single center 798 139 659 16 Cui et al9 2022, China Retrospective Multicenter 1194 END(ACS) 36
END(PCS) 13END(ACS) 906
END(PCS) 239No. Source(Author/Year/Country) Age, year, median(IQR) or mean±SD Gender(male), No.(%) Quality score Total END Non-END Total END Non-END 1 Boulenoir et al142020, France 64±10 62 (54-71) 64 (54-74) — 16 (73) 40 (77) 8 2 Che et al15 2020, China 63.42±11.33 64.47±9.34 63.34±11.48 673(60.79) 49(60.49) 624(60.82) 8 3 Huang et al16 2018, China 64.98±10.65 END(Identified causes) —
Unexplained END 72.93±6.8264.41±10.73 156(60.47) END(Identified causes) —
Unexplained END 7 (46.7)149 (61.3) 8 4 Tanaka et al17 2020, Japan 75 (66-82) ENDh 78 (67-87.25)
ENDi 75 (64-81)75 (66-82) 452 (60.8) ENDh 16 (72.7)
ENDi 30 (52.6)406 (61.1) 8 5 Li et al18 2019, China 66±12 60±9 63±13 116(83.45) 21(84.0) 95(83.3) 8 6 Li et al19 2021, China 65.3±8.7 66.9±6.5 64.8±5.7 69(76.67) 16(57.1) 53(58.9) 8 7 Liu et al20 2021, China 59.43±19.77 ≥60(years) 43
<60(years) 28≥60(years) 64
<60(years) 77113(53.3) 39 74 8 8 Mori et al21 2012, Japan 72.0±11.6 71.5±9.3 72.0±11.9 355(62.72) 38(67.85) 317(62.16) 8 9 Yu et al10 2020, United Kingdom 73(64.5–81.5) 76 (69–83) 72 (63-81) — 2077 (60.8) 27194 (57.4) 8 10 Seners et al22 2021, France 70±15 ENDh —
ENDi 69±1570±15 335 (46.0) ENDh —
ENDi 50 (57)282 (44.5) 8 11 Seners et al23 2014, France 69.1±14.6 END(Identified causes) —
Unexplained END 73.1±12.668.6±14.7 164 (53) END(Identified causes) —
Unexplained END 11 (48)150 (54) 8 12 Seners et al24 2017, France 69.4±15.3 75.7±11.4 68.0±15.8 56 (47) 8 (36) 48 (49) 8 13 Shah et al5 2022, USA 69.5±14.9 72±16 69±15 631(51) 50(55) 585(51) 8 14 Simonsen et al25 2016, Denmark — ENDh 73 (60.5–80.75)
ENDi 66 (61–74)66 (57–74) — ENDh 2 (57)
ENDi 18 (69)329 (61) 8 15 Wang et al26 2022, China 67 (11.4) 69 (12.5) 66 (11.1) 512 (64.2) 93 (66.9) 419 (63.6) 8 16 Cui et al9 2022, China END(ACS) 64 (56–72)
END(PCS) 62 (55–70)END(ACS) 63 (54–69)
END(PCS) 66 (53–73)END(ACS) 64 (56–72)
END(PCS) 62 (55–70)END(ACS) 640 (67.9)
END(PCS) 164 (65.1)END(ACS) 25 (69.4)END(PCS) 10 (76.9) END(ACS) 615 (67.9)END(PCS) 154 (64.4) 8 END - early neurological deterioration. Unexplained END and END without definite cause. ENDh - early neurological deterioration of presumed hemorrhagic origin. ENDi - Early neurological deterioration of presumed ischemic origin. END (ACS) - END in anterior circulation stroke (ACS) group. END (PCS) - END in posterior circulation stroke (PCS) group
- Table Supplementary 1
- Quality assessment of included studies using Newcastle Ottawa Scale(NOS).
NO. Source (Author/Year/Country) Newcastle Ottawa scale assessment(NOS) Selection Comparability Outcome Quality Score Is the case definition adequate? Representativ-eness of the cases Selection of Controls Definition of Controls Comparability of cases and controls on the basis of the design or analysis Ascertainm-ent of exposure Same method of ascertainment for cases and controls Non-Resp-onse rate 1 Boulenoir et al 2020, France * * * ** * * * Good 2 Che et al 2020, China * * * ** * * * Good 3 Huang et al 2018, China * * * ** * * * Good 4 Tanaka et al 2020, Japan * * * ** * * * Good 5 Li et al 2019, China * * * ** * * * Good 6 Li et al 2021, China * * * ** * * * Good 7 Liu et al 2021, China * * * ** * * * Good 8 Mori et al 2012, Japan * * * ** * * * Good 9 Yu et al 2020, United Kingdom * * * ** * * * Good 10 Seners et al 2021, France * * * ** * * * Good 11 Seners et al 2014, France * * * ** * * * Good 12 Seners et al.2017.France * * * ** * * * Good 13 Shah et al 2022, USA * * * ** * * * Good 14 Simonsen et al 2016, Denmark * * * ** * * * Good 15 Wang et al 2022, China * * * ** * * * Good 16 Cui et al 2022, China * * * ** * * * Good Study ES 95%CI Weight (%) LCI UCI Boulenoir et al 2020, France 0.30 0.20 0.41 4.51 Che et al 2020, China 0.07 0.06 0.09 6.86 Huang et al 2018, China 0.11 0.07 0.15 6.15 Tanaka et al 2020, Japan 0.11 0.08 0.13 6.74 Li et al 2019, China 0.18 0.12 0.25 5.44 Li et al 2021, China 0.24 0.16 0.32 5.22 Liu et al 2021, China 0.33 0.27 0.40 5.92 Mori et al 2012, Japan 0.10 0.08 0.13 6.62 Yu et al 2020, United Kingdom 0.07 0.07 0.07 7.13 Seners et al 2021, France 0.13 0.11 0.16 6.73 Seners et al 2014, France 0.11 0.07 0.15 6.26 Seners et al 2017, France 0.18 0.12 0.26 5.25 Shah et al 2022, USA 0.07 0.06 0.09 6.89 Simonsen et al 2016, Denmark 0.06 0.04 0.08 6.63 Wang et al 2022, China 0.17 0.15 0.20 6.76 Cui et al 2022, China 0.04 0.03 0.05 6.88 Overall (I2=95.88%, p=0.00) 0.12 0.10 0.15 100.00 Variables Tests for Publication Bias Egger’s test/Peter’s test Z score p-value Age -2.38 0.032 Gender(male) -2.21 0.045 Hypertension -0.41 0.691 Diabetes mellitus -0.86 0.401 Atrial fbrillation -1.64 0.126 Antihypertensives 1.89 0.199 Antiplatelets -4.33 0.003 Glycemia 0 1 DBP -1.96 0.082 SBP -0.47 0.647 WBC 2.05 0.177 TC 1.48 0.278 OTT -0.23 0.822 LAA -0.33 0.747
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