ABSTRACT NUMBER: ESOC2026A758 TRENDS IN HOSPITAL DISCHARGES WITH A DIAGNOSIS OF PEDIATRIC STROKE IN SPAIN: A NATIONWIDE ANALYSIS

Abstract Background and aims Pediatric stroke leads to significant morbidity, yet nationwide longitudinal data regarding its epidemiology are scarce. We analyzed temporal trends in incidence, demographics, and in-hospital mortality rates in Spain. Methods A retrospective analysis (2005-2022) included Ischemic (IS) and Hemorrhagic Stroke (HS) in patients > 28 days to < 16 years, using data from the National Statistics Institute Hospital Morbidity Survey. Incidence rates were standardized to the European Standard Population. Results We identified 2,774 pediatric stroke cases (60.1% HS, 39.9% IS). Mean age was 7.1 years (SD 5.2), with 58.4% males. Mean annual incidence was 2.19 cases per 100,000 children (95% CI 2.07–2.31); higher for HS (1.32; 95% CI 1.24–1.40) than IS (0.87; 95% CI 0.80–0.94). Median length of stay was longer for HS (10 days; IQR 4–20) than IS (8 days; IQR 3–13) (P < 0.001). Temporal trends showed rising incidence rates in females aged 5–9 (Rho = 0.72, P < 0.001) and males 10–15 (Rho = 0.70, P = 0.001), contrasting with declines in the 0–4 age group (Males: Rho = -0.66, P = 0.003; Females: Rho = -0.62, P = 0.006). Overall in-hospital mortality was 6.4%, with a higher Case Fatality Rate for HS (8.15%) than IS (3.71%) (P < 0.001). Conclusions Hemorrhagic stroke is the most frequent type of stroke in the Spanish pediatric population, accounting for the highest mortality and healthcare burden. A significant global shift in stroke epidemiology was identified, with rising incidence among adolescent males and school-aged females, and a marked reduction in stroke rates among children under 5 years of age. Conflict of interest Eduardo Mariño: Nothing to disclose. Figure 1 - belongs to Results