ABSTRACT NUMBER: ESOC2026A1167 ADDITIONAL BURDEN OF POST-STROKE DELIRIUM ON COGNITIVE AND FUNCTIONAL OUTCOME: ACUTE AND LONGITUDINAL ASSESSMENT OF POST-STROKE COGNITIVE IMPAIRMENT

Abstract Background and aims Post-stroke delirium (PSD) is a severe complication in acute stroke, associated with prolonged hospitalization and a higher rate of disability. Post-stroke cognitive impairment (PSCI) plays an essential role in long-term outcome but most studies assess PSCI after PSD or compare patients with healthy controls, limiting the distinction between stroke- and delirium-related PSCI and obscuring their temporal course. This study investigates the impact of PSD on PSCI during the acute phase and at 3-month follow-up (FU). Methods PSCI was assessed using a multi-component neuropsychological testing incorporated in a digital app (TuCAN) in 31 stroke patients. The primary endpoint was defined as between-group comparison of global PSCI (gPSCI) at 3-months FU. Secondary endpoints were domain-specific PSCI (dsPSCI), mRS, mortality and cognitive recovery at 3-month FU. Results PSD-patients had a significantly worse gPSCI than non-PSD stroke patients at 3-month FU (U = 19.500, p < 0.001), especially with the domain attention & processing speed (U = 17.500, p < 0.001) and executive functions (U = 31.500, p = 0.006). PSD-patients showed a significantly lower mRS (U = 34.500, p = 0.006), less good outcome (mRS ≤ 2) (χ2 = 4.979, df =1, p = 0.042), higher mortality rate (χ2 = 5.738, df =1, p = 0.041) and less cognitive recovery (χ2 = 6.217, df =1, p = 0.018) at 3-month FU. Conclusions This study demonstrates the additional burden of PSD and its role as a critical determinant on post-stroke outcomes and emphasizes the need for early identification and prevention. Conflict of interest All authors: Nothing to disclose.