Abstract TP137: Prevalence of Food Insecurity in Ischemic and Hemorrhagic Stroke: A Retrospective Analysis

Background: Food insecurity (FI) is physical, social and economic access to consistent and nutritious foods to meets one’s dietary needs. FI is more prevalent in ischemic stroke patients and associated with increased mortality. There is limited data differentiating food insecurity among ischemic stroke versus intracranial hemorrhage (ICH). Therefore, we compared food insecurity and its impact on outcomes among ischemic and hemorrhagic stroke patients. Methods: We performed a retrospective analysis of 242 ischemic and hemorrhagic stroke patients at a single comprehensive stroke center from 12/2026-12/2029. Using the Food Insecurity Index (FII), a number from 0-100 based on qualitative and quantitative measures of food insecurity within specific a zip code, we divided patients into quartiles. Poisson regression was used to compare stroke incidence and function outcomes and across four levels of FI among those with ischemic and hemorrhagic stroke (Quartile 1 served as the reference). This analysis was conducted using R version 4.3.2.. The Incidence Risk Ratios (IRR) were calculated with 95% confidence intervals (CIs) as well as levels of significance. Results: For ICH patients (Table 1), compared to Quartile 1 (least food insecure areas), Quartile 2 had 1.88 times the rate of ICH (p=0.014), those in Quartile 3 had 1.90 times the rate of ICH ( p=0.020), and those in Quartile 4 (most food insecure) had 2.23 times the rate of ICH ( p<0.001). For ischemic strokes (Table 2), Quartile 2 had 2.15 times the rate of stroke (p<0.001), those in Quartile 3 had 2.07 times the rate of stroke (p<0.001), and those in Quartile 4 (most food insecure) had 2.99 times the rate of stroke (p<0.001).Stroke severity as measured by discharge modified rankin scale (mRS) did not significantly differ by food insecurity quartile (p=0.373). Conclusion: Our data show that patients who reside in higher FI areas were more than twice as likely to have a hemorrhagic stroke, a continuous trend across the spectrum of nutrition insecurity levels also observed among those with ischemic stroke. In fact, those living in the highest FI regions had nearly three times more ischemic stroke compared to those residing in the lowest. However, food insecurity showed no clear impact on functional outcomes. Food insecurity may be a critical, modifiable risk for stroke, and further studies are needed to characterize, and quantify, its influence on cerebrovascular disease.