ABSTRACT NUMBER: ESOC2026YS170 NATIONWIDE, POPULATION-BASED COHORT STUDY OF EPILEPSY INCIDENCE IN PATIENTS WITH POST-STROKE APHASIA

Abstract Background and aims Epilepsy and aphasia significantly worsen post-stroke functional outcomes, yet the association between aphasia and epilepsy risk across age, sex, and stroke type remains unconfirmed in large-scale studies. Methods We used Taiwan’s National Health Insurance claims data to identify individuals aged 18 years or older hospitalized for a first stroke between 2003 and 2007. Patients diagnosed with aphasia during admission or within 90 days after discharge were classified as the aphasia cohort. Incidence of post-stroke epilepsy was tracked until December 31, 2020, and hazard ratios were derived using Cox proportional hazards regression. Results With a median follow-up of 7.56 years for the aphasia group (n = 23,431) and 8.67 years for the non-aphasia group (n = 130,058), the incidence of post-stroke epilepsy was higher among patients with aphasia compared with those without aphasia (13.02 vs. 4.56 per 1,000 person-years), yielding an adjusted hazard ratio (HR) of 1.65 (95% confidence interval [CI], 1.57–1.74). Elevated risk was consistent across subgroups: Female, 1.59 (1.45–1.74); Male, 1.63 (1.52–1.74); hemorrhagic stroke, 1.46 (1.35–1.59); and ischemic stroke, 1.71 (1.59–1.84). Analysis of 22,913 matched pairs showed consistent results (HR 1.69, 95% CI 1.58–1.81) across age, sex, and stroke type. Patients with post-stroke aphasia experience elevated epilepsy risk across age, sex, and stroke type. Conflict of interest Hui Lin: nothing to disclose; Joshua: nothing to disclose. Figure 1 - belongs to Methods Figure 2 - belongs to Results