ABSTRACT NUMBER: ESOC2026A1543 DYSPHAGIA IS A KEY PREDICTOR OF OUTCOME IN YOUNG STROKE ADULTS

Abstract Background and aims Young adults with acute ischemic stroke represent a distinct subgroup with more favourable outcomes than older patients, but higher professional and family reponsibilities at stroke onset. However, predictors of outcome in this population remain insufficiently characterized. Dysphagia is a frequent complication after stroke and is associated with adverse outcomes, but its prognostic relevance in younger stroke patients is poorly understood. Methods In this retrospective analysis, consecutive patients with acute ischemic stroke treated in two university hospitals between January 2020-June 2023 were analyzed. Patients aged ≤50 years were compared with patients >50 years. Multivariable linear regression analyses were performed to identify independent predictors of functional outcome, assessed by the ordinal modified rankin scale (mRS) at discharge. Results In total, n=5477 acute ischemic stroke patients were included in the study, n=297 (5.4%) were aged ≤50 years. Younger patients had lower pre-stroke disability, lower baseline NIHSS, suffered less frequently from motor deficits and dysphagia on admission, had fewer in-hospital complications, and better functional outcomes at discharge. In multivariable analyses, higher pre-stroke mRS, higher baseline NIHSS, and dysphagia on admission independently predicted poorer outcome in both groups. Dysphagia was the strongest predictor of worse outcome, in particular in the younger subgroup (ß-coefficient 1.27, 95% CI 0,74–1.79 vs. ß-coefficient 1.01, 95% CI 0.90–1.13). Conclusions Dysphagia is a key independent predictor of poor functional outcome in young stroke adults. Early detection and targeted management of dysphagia may be particularly important to optimise recovery in this prognostically favourable but vulnerable patient group. Conflict of interest Manuel Braida, Hans Pinnschmidt, Alexander Seiler and Daniela Berg have nothing to disclose. Georg Royl received compensation from Cardinal Health 200 LLC for consultant services, compensation from Novartis Pharma AG for other services, compensation from AstraZeneca for consultant services, travel support from Boehringer Ingelheim, compensation from Boehringer Ingelheim for consultant services, compensation from Ipsen Pharma SAS for consultant services and compensation from Bristol-Myers Squibb for consultant services. Milani Deb-Chatterji has received research grants from the Werner Otto Foundation, speakers honoraria from AstraZeneca and Boehringer Ingelheim and was funded by the Faculty of Medicine, University of Kiel, Germany through its Advanced Clinician Scientist Programme, all outside the submitted work.