Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
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Serum glial fibrillary acidic protein (GFAP) has been reported to have high diagnosis accuracy for differentiating intracerebral hemorrhage (ICH) from ischemic stroke (IS) in patients within acute phase of stroke symptom onset. Our purpose was to perform a systematic review and diagnostic meta-analysis to evaluate the valuation of serum GFAP in the early identification of ICH and IS. We searched MEDLINE, EMBASE and other electronic databases for diagnostic accuracy studies that compared serum GFAP with standard clinical diagnosis of ICH and IS in patients with symptoms of acute stroke. ⋯ The summarized estimates of serum GFAP for the differentiation of ICH and IS within 24 h of symptom onset were as follows: SEN, 81.1% (95% CI, 72.6-87.5%); SPE, 95.2% (95% CI 82.1-98.9%); PLR, 16.945 (95% CI 4.173-68.803); NLR, 0.198 (95% CI 0.133-0.296), significant heterogeneity was present. The four summary estimates of serum GFAP for patients within 1-6 h of symptom onset were 81.1% (95% CI 72.5-88.0%), 97.0% (95% CI 94.3-98.4%), 26.786 (95% CI 13.979-51.324), 0.191 (95% CI 0.126-0.291), respectively, with no obvious heterogeneity. Serum GFAP is a sensitive and specific test for differentiating ICH and IS in patients within 1-6 h of acute stroke symptom onset.