ABSTRACT NUMBER: ESOC2026A445 EXAMINING GENDER DISPARITIES IN MORTALITY AFTER ISCHEMIC STROKE: INSIGHTS FROM A NATIONWIDE REGISTRY OF 74,840 PATIENTS

Abstract Background and aims Ischemic stroke (IS) is one of the leading causes of mortality and disability worldwide. This study examined sex-specific differences in short- and long-term mortality following IS. Methods Mortality outcomes in patients (n = 78,840, 57.3% male, Figure 1) were assessed at 30 days, 1 year, 5 years, and 10 years post-stroke through Cox proportional hazards models adjusted for demographic and cerebrovascular risk factors. Multivariable models adjusted for demographic and cerebrovascular risk factors. Interaction analyses were performed to evaluate sex-specific differences in the effect sizes of individual risk factors. Results Females demonstrated a higher risk of mortality at 30 days , 1 year, and 5 years following IS with univariate models. This association was attenuated at 10 years. With multivariate models, female sex was associated with a significantly lower risk of mortality across all time points: 30 days, 1 year, 5 years, and 10 years (Figure 2). Interaction analyses demonstrated significant sex-specific differences in the prognostic impact of several risk factors. History of atrial fibrillation, ischemic heart disease, and increasing age were associated with a greater increase in mortality risk in females as compared to males, whereas diabetes mellitus and hyperlipidaemia conferred a greater increase in mortality risk in males than females (Figure 3). Conclusions Female sex was identified to be independently associated with lower post-stroke mortality. While traditional risk factors remain strong predictors of post-stroke mortality, their effects differ by sex, supporting the importance of incorporating sex-specific considerations into post-stroke risk management. Conflict of interest Ren Ying Tan: nothing to disclose. Hao Min Cheo: nothing to disclose. Hon Jen Wong: nothing to disclose. Chen Ee Low: nothing to disclose. Chun En Yau: nothing to disclose. Bernard PL Chan: nothing to disclose. Gregory YH Lip: nothing to disclose. Ching-Hui Sia: nothing to disclose. Leonard LL Yeo: nothing to disclose. Benjamin YQ Tan: nothing to disclose. Figure 1 - belongs to Methods Figure 2 - belongs to Results Figure 3 - belongs to Results