Background: Early neurological deterioration (END), generally defined
as the increment of National Institutes of Health Stroke Scale (NIHSS) score
4 within 24 hours, lead to poor clinical outcome in acute ischemic stroke
(AIS) patients receiving reperfusion therapies including intravenous thrombolysis
(IVT) and/or endovascular treatment (EVT). This systematic review and
meta-analysis aimed to explore multiple predictors of END following reperfusion
therapies. Methods: We searched PubMed, Web of Science and EBSCO for all
studies on END in AIS patients receiving IVT and/or EVT published between January
2000 and December 2022. A random-effects meta-analysis was conducted and
presented in accordance with the Preferred Reporting Items for Systematic Reviews
and Meta-Analysis (PRISMA) guidelines. The quality of each included studies was
assessed by calculating a total score according to the STROBE or CONSORT
criteria. Publication bias and heterogeneity were also evaluated using the
Eggers/Peters test, funnel plots and sensitivity analysis. Results: A
total of 29 studies involving 65,960 AIS patients were included. The quality of
evidence is moderate to high, and all studies have no publication bias. The
overall incidence of END occurring after reperfusion therapy in AIS patients was
14% ((95% confidence intervals (CI), 12%–15%)). Age, systolic blood pressure (SBP), glucose levels at
admission, the onset to treatment time (OTT), hypertension, diabetes mellitus,
arterial fibrillation, and internal cerebral artery occlusion were significantly
associated with END following reperfusion therapy. Conclusions: Numerous
factors are associated with END occurrence in AIS patients receiving reperfusion
therapy. Management of the risk factors of END may improve the functional outcome
after reperfusion treatment.