ABSTRACT NUMBER: ESOC2026A1494 THE IMPACT OF PRESTROKE COGNITIVE IMPAIRMENT ON FUNCTIONAL OUTCOME AND IN-HOSPITAL MORTALITY OF PATIENTS WITH AN ACUTE CEREBROVASCULAR DISEASE

Abstract Background and aims One third of patients with acute cerebrovascular events has a prestroke cognitive impairment (preSCI). Aim of this study was to assess the impact of preSCI on length of hospitalization, functional outcome at discharge, and in-hospital mortality. Methods Consecutive patients admitted to the stroke unit from April 2019 to February 2024 were included. The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) was administered to caregivers. PreSCI was diagnosed if the mean IQCODE score was >3.3. In the subgroup of ischemic stroke patients, a binary logistic regression model was built with in-hospital mortality as the dependent variable. Results 809 patients were included: 45.2% women; median age 78.0 years (68.0-85.0); median NIHSS score 3.0 (1.00-8.00). An IQCODE could be obtained in 733 patients (90.6%). PreSCI was present in 235 patients (32.1%). Patients with preSCI were older (p<0.001), more often female (p=0.002), had higher rates of hypertension (p=0.002) and atrial fibrillation (p<0.001) and more severe strokes (p<0.001). At discharge, patients with preSCI had longer hospitalizations (p<0.001), higher disability (p<0.001), and a higher death rate (p<0.001). In the ischemic stroke subgroup, predictors of in-hospital mortality were stroke severity (OR 1.205, 95%CI 1.123-1.293) and preSCI (OR 3.373, 1.199-9.489]). Conclusions Our study confirms the association of preSCI with older age, female sex, and vascular risk factors. It also shows that the standardized assessment of prestroke cognitive status with the IQCODE at the time of admission to the stroke unit provides useful information about length of hospitalization, functional disability at discharge, and in-hospital mortality. Conflict of interest FM, IC, GS, AN, GM, AF, VC, FM, ES, LP: nothing to disclose