ABSTRACT NUMBER: ESOC2026A1985 SEX- AND GENDER-RELATED DIFFERENCES IN MORTALITY AND REHABILITATION AFTER ISCHEMIC STROKE IN UKRAINE: A NATIONWIDE ANALYSIS

Abstract Background and aims Sex- and gender-related disparities in ischemic stroke outcomes remain insufficiently explored in Ukraine, particularly within publicly funded healthcare systems. Using nationwide data from Ukraine, we aimed to assess sex differences in in-hospital mortality and gender-related differences in access to post-stroke rehabilitation among patients treated for acute ischemic stroke. Methods A nationwide, retrospective, observational study was conducted using data from a centralized national health database - Health Service of Ukraine. The analysis included all patients hospitalized with ischemic stroke between 1 January and 15 December 2025 and treated under the Medical Guarantees Program. Descriptive statistical analyses were performed using Microsoft Excel and SPSS, with group comparisons conducted using chi-squared tests. Results A total of 96,683 patients were analyzed (47,366 women and 49,317 men). Crude in-hospital mortality was higher in women than in men (15.7% vs 12.4%; p<0.001). However, age-stratified analyses showed no statistically significant differences in mortality between women and men. Among stroke survivors, rehabilitation utilization was significantly higher in men compared with women (32.0% vs 22.8%; p<0.001), with statistically significant differences observed across most age categories, including 0–24, 40–49, 50–59, 60–69, 70–79, and 80–89 years. Conclusions Nationwide data show that women with ischemic stroke have higher overall in-hospital mortality, however, age-stratified analyses revealed no significant sex differences. In contrast, men are more likely to receive post-stroke rehabilitation, reflecting significant gender-related disparities. These findings highlight sex- and gender-related inequitie in publicly funded stroke care and the need for age-adjusted, system-level interventions. Conflict of interest Yunkai Cui: nothing to disclose, Kateryna Potapova: nothing to disclose, Maria Prokopiv: nothing to disclose.