Early Fibrinogen‐to‐Albumin Ratio and Poor Functional Outcome After Acute Ischemic Stroke: A Systematic Review and Meta‐Analysis

Figures

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  FIGURE 1. Study selection. The preferred reporting items for systematic reviews and meta‐analyses (PRISMA) 2020 flow diagram shows records identified, duplicates removed, reports assessed in full, and studies included in the systematic review and meta‐analysis.

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  FIGURE 2. Risk‐of‐bias assessment of the included studies using the Quality In Prognosis Studies (QUIPS) tool. Cells show the final consensus judgments of two independent reviewers (low, moderate, or high risk of bias) for each study and domain.

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  FIGURE 3. Association between early fibrinogen‐to‐albumin ratio and poor functional outcome after acute ischemic stroke. (A) Adjusted odds ratios comparing study‐defined high and low FAR categories. (B) Adjusted odds ratios per 1‐unit increase in FAR_100, defined as fibrinogen (g/L) divided by albumin (g/L) and multiplied by 100. The left table reports sample sizes, adjusted ORs with 95% CIs, random‐effects weights, pooled‐effect p values, and I 2. p values are from two‐sided modified Hartung–Knapp tests of the pooled null OR = 1; I 2 is Q‐based. Squares and horizontal lines show study‐specific estimates and 95% CIs; square size reflects the random‐effects weight. Diamonds show pooled estimates. Arrowheads indicate point estimates or confidence limits beyond the plotted axis. CI, confidence interval; FAR, fibrinogen‐to‐albumin ratio; OR, odds ratio.

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  FIGURE 4. Leave‐one‐out and continuous‐scale robustness analyses. (A and B), Pooled adjusted odds ratios after omission of each study from the categorical and continuous analyses, respectively. (C) Primary continuous estimate compared with two nested scale‐restriction analyses. Each panel places a complete numerical table beside the forest plot. p values are from two‐sided modified Hartung–Knapp tests of the pooled null OR = 1; I 2 is Q‐based. Dashed vertical lines indicate the primary pooled estimate, and dotted vertical lines indicate the null value. Estimates were obtained using restricted maximum likelihood random‐effects models with modified Hartung–Knapp 95% confidence intervals. Continuous estimates are reported per 1‐unit increase in FAR_100, where FAR_100 is fibrinogen (g/L) divided by albumin (g/L) and multiplied by 100. CI, confidence interval; FAR, fibrinogen‐to‐albumin ratio; OR, odds ratio.