SynthesisFrontiers in neurology2026
Association between the Fibrosis-4 index and stroke and related outcomes: a meta-analysis.
Synthesis in Frontiers in neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
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Authors and funding
3 authors.
Funding
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Abstract
Objective: This meta-analysis evaluated the associations between the Fibrosis-4 index (FIB-4) and overall stroke, ischemic stroke, hemorrhagic outcomes, poor functional outcome, and all-cause mortality. Methods: PubMed, Embase, and the Cochrane Library were searched from inception to November 4, 2025. Cohort and cross-sectional studies evaluating categorical or continuous FIB-4 were eligible. Quantitative syntheses were stratified by outcome, FIB-4 modeling approach, and effect measure, with odds ratios (ORs) and hazard ratios (HRs) analyzed separately. Prediction intervals were calculated for random-effects analyses containing at least three independent estimates. Results: Twenty-two studies, including 20 cohort studies and two cross-sectional studies, were included, of which 20 contributed to at least one quantitative synthesis. Elevated categorical FIB-4 was associated with greater odds of overall stroke (OR = 1.86, 95% CI: 1.63-2.14), ischemic stroke (OR = 2.03, 95% CI: 1.72-2.40), symptomatic intracranial hemorrhage (OR = 2.52, 95% CI: 1.79-3.53), poor functional outcome (OR = 2.88, 95% CI: 2.47-3.35), and all-cause mortality (OR = 2.98, 95% CI: 2.51-3.53). Continuous FIB-4 was also associated with overall stroke (HR = 1.08, 95% CI: 1.02-1.14), symptomatic intracranial hemorrhage (OR = 1.33, 95% CI: 1.20-1.48), poor functional outcome (OR = 1.26, 95% CI: 1.11-1.43), and all-cause mortality (HR = 1.08, 95% CI: 1.03-1.12). However, prediction intervals crossed the null for the continuous analyses of poor functional outcome and all-cause mortality, and the categorical overall-stroke analysis was exploratory. Conclusion: Higher FIB-4 was associated with stroke and adverse stroke-related outcomes across several observational analyses. FIB-4 may provide adjunctive risk information, but prospective validation and formal assessment of its incremental clinical value are required before routine implementation. Systematic review registration: https://www.crd.york.ac.uk/prospero/search, identifier: CRD420251207801.
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