Table 1.
Basic characteristics of the studies included in the meta-analysis.
| ID | References | Country | Duration | Design | Sample size (male) | Age (year) | Admission NIHSS | Treatment | Bridging therapy, n (%) | Blood; collection; time | Study; outcome | NRL cut-off | sICH; definition | Infection excluded | NOS; scores |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Brooks et al. (21) | USA | 2008–2011 | R (S) | 116 (NR) | 67 (18–93) | 17 (1–48) | EVT | 27 (23.3) | Admission | (1) PFO; (2) Mortality | 5.9 | NR | No | 7 |
| 2 | Maestrini et al. (17) | France; Finland | NR | P (D) | 846 (430) | 71 (60–80) | 10 (6–16) | IVT | 56 (6.6) | Before IVT | (1) PFO; (2) sICH; (3) Mortality | 4.8 | ECASS II | No | 9 |
| 3 | Pagram et al. (33) | Australia | 2009–2013 | R (S) | 141 (NR) | 74.3 ± 10.7 | 10.1 ± 4.7 | IVT | NP | Before IVT; after IVT | PFO | NR | NR | NR | 8 |
| 4 | Guo et al. (15) | China | 2012–2015 | R (D) | 189 (123) | 65.0 ± 10.6 | 12 (6–16) | IVT | 58 (30.7) | Admission; after IVT | sICH | NR | ECASS II | Yes | 9 |
| 5 | Inanc et al. (34) | Turkey | 2014–2015 | R (S) | 56 (35) | 58.23 ± 11.94 | 16.09 ± 3.33 | EVT | NR | Admission | (1) sICH; (2) Mortality | NR | NR | Yes | 6 |
| 6 | Goyal et al. (18) | USA | 2012–2016 | R (S) | 293 (147) | 62 ± 14 | 16 (13–19) | EVT | 240 (70.0) | Admission | (1) PFO; (2) sICH; (3) Mortality | NR | SITS-MOST | NR | 8 |
| 7 | Wang et al. (35) | China | 2014–2016 | R (M) | 199 (128) | 64 (55–72) | 16 (13–21) | EVT | 85 (42.7) | Admission | PFO | NR | HBC | Yes | 7 |
| 8 | Duan et al. (36) | China | 2014–2016 | R (M) | 616 (368) | 66 (57–74) | 16 (12–21) | EVT | 216 (35.1) | Before EVT | (1) PFO; (2) sICH; (3) Mortality | 7 | HBC | Yes | 8 |
| 9 | Malhotra et al. (37) | USA | 2011–2015 | R (D) | 657 (333) | 64 ± 14 | 7 (4–13) | IVT | 52 (7.9) | Before IVT | (1) PFO; (2) sICH; (3) Mortality | 2.2 | SITS-MOST | No | 9 |
| 10 | Shi et al. (38) | China | 2009–2016 | P (S) | 372 (242) | 64 | 10.9 ± 6.8 | IVT | NP | Before IVT; after IVT | (1) PFO; (2) Mortality | NR | ECASS II | Yes | 8 |
| 11 | Semerano et al. (39) | Spain | 2008–2017 | R (M) | 433 (266) | 71 (61–80) | 17 (11–21) | EVT | 213 (49.0) | Before EVT; after EVT | (1) PFO; (2) sICH; (3) Mortality | NR | ECASS II | No | 7 |
| 12 | Pektezel et al. (40) | Turkey | 2009–2018 | R (S) | 142 (62) | 69 ± 13 | 13.9 ± 5.5 | IVT | NP | Before IVT; after IVT | (1) PFO; (2) sICH | NR | ECASS II | No | 6 |
| 13 | Li et al. (41) | China | 2017–2019 | R (S) | 156 (107) | 64.43 ± 12.60 | 13 (11–17) | EVT | 66 (42.31) | Admission | sICH | NR | ECASS III | NR | 7 |
| 14 | Ying et al. (42) | China | 2016–2018 | R (S) | 208 (129) | 67.3 ± 12.4 | NR | IVT | NP | Admission; after IVT | (1) PFO; (2) sICH | NR | ECASS II | Yes | 8 |
| 15 | Meng et al. (43) | China | 2015–2019 | P (S) | 302 (171) | 69 ± 11 | 14.4 ± 4.6 | EVT | 115 (38.1) | Admission | (1) PFO; (2) Mortality | 6.45 | HBC | No | 8 |
| 16 | Lv et al. (44) | China | 2016–2019 | R (S) | 564 (409) | 63.0 (54.0–70.8) | 8 (5–12) | IVT | NP | Before IVT | PFO | NR | NR | NR | 7 |
| 17 | Oh et al. (45) | Korea | 2014–2019 | R (S) | 411 (222) | 69.2 ± 13.4 | 10.4 ± 6.6 | EVT | 152 (37.0) | Before EVT | (1) PFO; (2) sICH; (3) Mortality | 5.1 | ECASS III | Yes | 8 |
| 18 | Cheng et al. (46) | China | 2016–2019 | R (S) | 381 (253) | 68 (59–76) | 7.0 (3.5–11.0) | IVT | NP | after IVT | PFO | NR | NR | Yes | 7 |
| 19 | Liu et al. (47) | China | 2016–2019 | R (S) | 192 (138) | 60.8 ± 11.7 | 5.0 (3.0–6.8) | IVT | NP | Before IVT | PFO | 3.9 | NR | Yes | 7 |
| 20 | Switońska et al. (48) | Poland | 2017–2018 | R (S) | 51 (22) | 67 (55–78) | 11 (6–16) | IVT/EVT | 17 (33.0) | Admission | sICH | NR | ECASS II | Yes | 6 |
| 21 | Ozgen et al. (49) | Turkey | 2017–2018 | P (S) | 150 (83) | NR | NR | EVT | NP | Admission | (1) PFO; (2) Mortality | NR | NR | Yes | 7 |
| 22 | Pan et al. (50) | China | 2016–2018 | R (S) | 151 (97) | 68 (59–74) | 9 (6–14) | IVT | NP | Admission; after IVT | PFO | NR | NR | Yes | 7 |
| 23 | Lux et al. (51) | UK | 2016–2017 | R (S) | 121 (58) | 66.4 ± 16.7 | 19 (1–28) | EVT | 94 (77.6) | Admission; after EVT | PFO | NR | ECASS I | Yes | 8 |
| 24 | Aly et al. (19) | USA | 2015–2019 | R (S) | 142 (69) | 70 ± 16 | 17 (12–21) | EVT | 70 (49.0) | Admission; after EVT | (1) PFO; (2) sICH; (3) Mortality | NR | ECASS III | Yes | 7 |
| 25 | Hu et al. (52) | China | 2014–2019 | R (S) | 183 (123) | 64.9 ± 10.5 | 4 (3–7) | IVT | NP | after IVT | PFO | NR | NR | Yes | 8 |
| 26 | Topcuoglu et al. (53) | Turkey | 2011–2019 | R (S) | 165 (96) | 70 ± 14 | 13 ± 5.6 | IVT | NP | Before IVT; after IVT | (1) PFO; (2) sICH | NR | ECASS I | Yes | 6 |
| 27 | Majid et al. (54) | Pakistan | 2015–2019 | R (S) | 98 (60) | 58.0 ± 6.4 | 15.9 ± 7.7 | IVT | NP | Admission | PFO | 2.39 | NR | Yes | 6 |
| 28 | Chen et al. (55) | China | 2015–2019 | R (S) | 257 (186) | 63.2 ± 12.6 | NR | EVT | 115 (44.7) | Admission | (1) PFO; (2) sICH | NR | ECASS II | Yes | 8 |
| 29 | Ören et al. (20) | Turkey | 2016–2018 | R (S) | 133 (81) | 66.56 ± 12.47 | 13 (10–17) | IVT | NR | Admission | sICH | NR | ECASS III | Yes | 8 |
| 30 | Guo et al. (56) | China | 2014–2020 | R (M) | 1200 (756) | 66.9 ± 12.5 | NR | IVT | NP | Admission | sICH | NR | ECASS II | Yes | 9 |
| 31 | Yu et al. (57) | China | 2018–2020 | R (S) | 102 (54) | 66.9 ± 13.89 | 13.5 (9.75–17.00) | EVT | 33 (32.3) | Admission | sICH | NR | HBC | NR | 7 |
| 32 | Weng et al. (58) | China | 2016–2019 | R (S) | 291 (104) | 67 (59–79) | 8 (5–13) | IVT | NP | Admission; after IVT | Mortality | NR | NR | NR | 7 |
| 33 | Ferro et al. (59) | Portugal | 2017–2019 | R (S) | 325 (161) | 75 (66–83) | 14 (8–19) | IVT/EVT | 87 (26.7) | After IVT (EVT) | PFO | NR | NR | No | 8 |
| 34 | Yi et al. (60) | Korea | 2015–2020 | R (S) | 440 (260) | 70.2 ± 12.9 | NR | EVT | 159 (36.1) | Admission | PFO | 3.7 | ECASS III | Yes | 7 |
| 35 | Chen et al. (61) | China | 2016–2019 | R (S) | 280 (179) | 69 (59–77) | NR | IVT | NP | Admission | (1) PFO; (2) Mortality | NR | NR | NR | 7 |
| 36 | Xie et al. (62) | China | 2014–2020 | R (S) | 462 (318) | 63.3 ± 12.5 | NR | IVT | NP | Before IVT | sICH | NR | ECASS II | NR | 8 |
| 37 | Yang et al. (63) | China | 2016–2020 | R (D) | 623 (403) | 67.36 ± 12.84 | 6 (4–10) | IVT | NP | Admission; after IVT | (1) PFO; (2) Mortality | NR | NR | Yes | 6 |
| 38 | Shi et al. (64) | China | 2015–2017 | R (S) | 127 (65) | 70.95 ± 12.24 | 20 (16–25) | EVT | 53 (41.7) | Admission; after EVT | PFO | NR | HBC | NR | 7 |
| 39 | Gao et al. (65) | China | 2016–2019 | R (S) | 283 (180) | NR | NR | IVT | NP | Before IVT | PFO | NR | NR | NR | 7 |
| 40 | Li et al. (66) | China | 2018–2020 | R (S) | 286 (167) | 70 (63–77) | 18 (12–30) | EVT | 41 (14.3) | Before EVT | PFO | NR | ECASS II | NR | 8 |
| 41 | Lee et al. (67) | Korea | 2015–2011 | R (M) | 282 (162) | 69.5 ± 13.4 | NR | EVT | 148 (52.5) | Before EVT | PFO | NR | NR | NR | 6 |
| 42 | Sun et al. (68) | China | 2017–2019 | R (M) | 147 (75) | 67 (59–75) | 16 (11–19) | EVT | 302 (29.3) | Admission | PFO | 4.1 | HBC | NR | 8 |
| 43 | Zou et al. (69) | China | 2017–2020 | R (S) | 160 (101) | 70 (64–76) | 15 (11–20) | EVT | 12 (7.5) | After EVT | PFO | 9.75 | HBC | Yes | 6 |
| 44 | Weyland et al. (70) | Germany | 2014–2019 | R (S) | 549 (273) | 74.3 ± 12.6 | NR | EVT | 307 (55.9) | Admission | PFO | NR | NR | NR | 8 |
| 45 | Liao et al. (22) | China | 2014–2019 | R (M) | 586 (443) | 64 (56–73) | 27 (17–33) | EVT | 109 (18.6) | Admission | (1) PFO; (2) Mortality | NR | HBC | No | 8 |
| 46* | Chen et al. (71) | China | 2018–2020 | R (S) | 576 (379); 351 (249) | 68 (59–76); 69 (60–76) | 5 (3–10); 14 (11–19) | IVT; EVT | NP; 88 (25.1) | Before IVT/EVT; after IVT/EVT | (1) PFO; (2) sICH; (3) Mortality | NR | ECASS II | No | 8 |
| 47 | Shen et al. (72) | China | 2019–2020 | R (S) | 369 (250) | 66 (57–74) | 15 (12–19) | EVT | 80 (21.7) | Admission | sICH | 5.48 | HBC | NR | 7 |
| 48 | Sun et al. (73) | China | 2017–2019 | R (M) | 1227 (776) | 66 (56–73) | 16 (12–20) | EVT | 357 (29.1) | Admission | sICH | NR | ECASS II | NR | 7 |
| 49 | Sadeghi et al. (74) | Hungary | 2016–2018 | R (S) | 285 (159) | 66 ± 12.9 | 6.0 (5.0–9.1) | IVT | NP | Before IVT; after IVT | sICH | NR | ECASS II | NR | 6 |
| 50 | Kim et al. (75) | Korea | 2013–2019 | R (S) | 128 (67) | 68.9 ± 13.2 | 17 (13–21) | EVT | 50 (39.1) | Before EVT; after EVT | sICH | NR | SITS-MOST | Yes | 7 |
| 51 | Li et al. (16) | China | 2015–2021 | R (S) | 258 (156) | 70 s(61–79) | NR | EVT | 88 (34.1) | Before EVT; after EVT | PFO | NR | ECASS III | NR | 8 |
| 52 | Feng et al. (76) | China | 2019–2021 | R (S) | 170 (115) | 66.0 (58.8–74.3) | 15 (12–19) | EVT | 62 (36.5) | Admission; after EVT | PFO | NR | NR | No | 7 |
NOS, Newcastle–Ottawa Scale; NIHSS, National Institute of Health Stroke Scale; sICH, symptomatic intracranial hemorrhage; PFO, poor functional outcome; ECASS, European Cooperative Acute Stroke Studies; SITS-MOST, Safe Implementation of Thrombolysis in Stroke-Monitoring Study; HBC, Heidelberg Bleeding Classification; R, retrospective cohort; P, prospective cohort; S, single-center; B, dual-center; M, multi-center; NP, bridging therapy not performed; NR, not reported; IVT, intravenous thrombolysis; EVT, endovascular treatment; NRL, neutrophil-to-lymphocyte ratio.
*This study reported separately on the IVT and EVT groups.