ABSTRACT NUMBER: ESOC2026A874 PREDICTORS OF RECURRENT STROKE AND MORTALITY IN PATIENTS WITH HOUSING INSTABILITY: A MULTICENTER COHORT STUDY

Abstract Background and aims Housing instability is associated with poor health outcomes, yet the risk factors for recurrent stroke and mortality in this population remain unclear. Understanding these predictors can improve monitoring and interventions for high-risk patients. Our aim is to identify factors associated with recurrent stroke and subsequent all-cause mortality among patients experiencing housing instability Methods A total of 643 patients with indicators of housing instability were included from Al-Hussein University Hospital, Cairo Fatemia Hospital, and Al-Zahra University Hospital between April 2022 and May 2025. Patients with incident stroke were followed for recurrence and mortality. Disease-related factors, outpatient care, and participation in supportive programs were analyzed using logistic regression within a discrete-time survival framework. Results During follow-up, 56 patients (8.7%) experienced recurrent stroke, while 587 (91.3%) did not. Receipt of any level of primary care visits was associated with reduced odds of recurrent stroke. Comorbid conditions linked to higher risk included hypertension (aOR 1.35, 95% CI: 1.15–1.59), diabetes (aOR 1.21, 95% CI: 1.07–1.36), and renal disease (aOR 1.17, 95% CI: 1.02–1.35). Participation in supportive housing programs was associated with lower odds of all-cause mortality (high-level support: aOR 0.65, 95% CI: 0.60–0.71; low-level support: aOR 0.66, 95% CI: 0.60–0.73). Conclusions Among patients with housing instability, comorbidities and reduced access to care increase the risk of recurrent stroke, whereas engagement in supportive programs decreases mortality. Targeted monitoring and intervention strategies are essential to improve outcomes in this vulnerable population. Conflict of interest NOTHING TO DISCLOSE