• Liwei Zhou, Zhengye Jiang, Guowei Tan, and Zhanxiang Wang.
• The School Of Clinical Medicine, Fujian Medical University, Fuzhou City, China; Department of Neurosurgery, First Affiliated Hospital of Xiamen University, Xiamen City, China.
• World Neurosurg. 2021 Mar 1; 147: 23-28.

BackgroundThe island sign of non-contrast computed tomography is a risk factor for hematoma expansion (HE) after spontaneous intracerebral hemorrhage, but has inconsistent conclusions. A meta-analysis was performed to investigate the predictive accuracy of island sign for HE.MethodsA systematic review of published literature on island sign and hematoma expansion was conducted. The pooled sensitivity, specificity, and summary receiver operating characteristics curve (SROC) were generated. The publication bias was assessed by Deeks' funnel plot asymmetry test.ResultsNine studies with a total of 2939 patients were included in the present study. The pooled sensitivity and specificity of island sign for predicting hematoma expansion was 0.50 and 0.89, respectively. The area under the curve was 0.73 in the SROC curve. There was no significant publication bias.ConclusionsThis meta-analysis suggests that island sign of non-contrast computed tomography has a good predictive accuracy for hematoma enlargement in intracerebral hemorrhage.Copyright © 2020 The Author(s). Published by Elsevier Inc. All rights reserved.

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