ABSTRACT NUMBER: ESOC2026A843 IMPACT OF PRE-EXISTING PARKINSON’S DISEASE ON ACUTE STROKE SEVERITY, COMPLICATIONS, AND EARLY OUTCOMES: A MATCHED RETROSPECTIVE COHORT STUDY

Abstract Background and aims The impact of pre-existing Parkinson’s disease (PD) on the clinical course and recovery from acute ischemic stroke is not well defined. This study compared in-hospital complications, early functional outcomes, and neurological improvement between stroke patients with and without PD. Methods In a retrospective matched cohort study, 12 stroke patients with pre-existing PD were compared to 36 non-PD stroke controls, matched 1:3 for age (±5 years), sex, and admission NIHSS score (±3 points). Outcomes included discharge modified Rankin Scale (mRS), unfavorable functional outcome (mRS ≥3), in-hospital mortality, pneumonia, dysphagia, atrial fibrillation (AF), and neurological improvement (Delta NIHSS: admission-discharge NIHSS). Statistical analyses employed Mann-Whitney U, Fisher's exact tests, and significance was set at p<0.05. Results The cohorts were well-balanced in matched variables. While discharge mRS distribution (p=0.116) and the rate of unfavorable outcome (83.3% vs. 66.7%; p=0.465) did not differ significantly, PD patients exhibited significantly less neurological improvement (median Delta NIHSS: 3 vs. 7; p=0.011). In-hospital mortality (33.3% vs. 22.2%; p=0.462) and complications like pneumonia (66.7% vs. 47.2%; p=0.324) and dysphagia (66.7% vs. 52.8%; p=0.510) were numerically higher in the PD group, but not statistically significant. AF was less frequent in PD patients (41.7% vs. 69.4%; p=0.101). Conclusions Despite similar baseline stroke severity, patients with pre-existing PD showed significantly reduced early neurological recovery during hospitalization, with consistent, non-significant trend toward higher complication rates and poorer functional outcomes. These findings suggest PD as a potential marker of impaired post-stroke neurorecovery and emphasize the need for vigilant, specialized care in this vulnerable population. Conflict of interest This study was funded by the National Agency for Research and Development (NARD) of the Republic of Moldova, research project no. 25.80012.8007.04TC.