ABSTRACT NUMBER: ESOC2026A1233 REAL-WORLD CHARACTERISTICS AND OUTCOMES OF ISCHEMIC STROKE: A PERUVIAN MULTICENTER ANALYSIS FROM THE RES-Q REGISTRY

Abstract Background and aims To characterize and compare clinical profiles, care times, and functional outcomes in patients with acute ischemic stroke (AIS) in the Peruvian healthcare system using real-world data from the RES-Q registry. Methods We conducted a retrospective multicenter cohort study including adult patients with AIS registered in RES-Q between January 2023 and June 2025 across five hospitals in Peru. The primary exposure was intravenous thrombolysis (IVT). Results Among 1,780 AIS patients, 252 (14.2%) received IVT. Despite presenting with more severe strokes (higher median NIHSS, p<0.001), thrombolyzed patients achieved higher rates of functional independence at discharge compared with non-IVT patients (50.7% vs. 38.3%, p<0.001). In multivariable analysis, absence of IVT was independently associated with poor functional outcome (adjusted OR 1.30). Median door-to-needle time was 68 minutes. Rates of in-hospital mortality were similar between groups (7.14% vs. 5.76%, p=0.389), and sICH rates remained low. Independent predictors of poor functional outcome included higher NIHSS (aOR 1.20 per point, 95% CI 1.16–1.24), older age (aOR 1.01 per year, 95% CI 1.00–1.02), and diabetes(aOR 1.45, 95% CI 1.05–1.99). Predictors of in-hospital mortality were NIHSS (aOR 1.25, 95% CI 1.19–1.32) and diabetes (aOR 2.21, 95% CI 1.12–4.38).. Conclusions his real-world multicenter Peruvian study demonstrates that IVT is feasible, safe, and associated with improved functional outcomes despite treatment of a more severely affected cohort. The findings highlight opportunities for quality improvement, particularly reducing door-to-needle times and improving access to reperfusion therapies. Conflict of interest Marla Gallo. nothing to disclose