ABSTRACT NUMBER: ESOC2026YS171 THE GLOBAL STROKE OUTCOMES STUDY: PRELIMINARY RESULTS

Abstract Background and aims Acute ischemic stroke (AIS) is a leading cause of death and disability worldwide. Thrombolysis, mechanical thrombectomy (MT) and surgical decompression are gold standard treatments for AIS due to large-vessel occlusion (LVO), yet access varies across regions. The Global Stroke Outcomes study provides an international overview of patient characteristics, care pathways, and outcomes for AIS due to LVO. Methods This prospective, multicenter, international observational study recruited sites globally through collaborations including Mission:Brain, Mission Thrombectomy, and regional networks. Centers completed site questionnaires and prospectively collected patient data using standardized case report forms over 30 days. All patients presenting with AIS due to LVO were included irrespective of treatment. Outcomes were discharge status, 30-day mortality, and treatments. Results Data from 21 sites and 282 patients were analyzed. Most sites were urban (90.5%) and tertiary centers (90.5%). All sites had access to internal medicine, emergency medicine, intensive care, and neurosurgery; only 61.9% had neurointerventional radiology or angiography suites. MT specialties varied. Of 54 MT-eligible patients, 79.7% underwent the procedure. 8.7% received thrombolysis, and 2.0% underwent decompressive craniectomy. Variation occurred in imaging and antiplatelet use. At discharge, 80% returned home where the median Glasgow Coma Scale (GCS) before discharge was 15. Significant global variation exists in access to AIS treatments including MT, specialized teams, and management practices for AIS due to LVO. These differences may contribute to outcome variability beyond current MT guidelines. Conflict of interest All authors have nothing to disclose.