ABSTRACT NUMBER: ESOC2026A1051 GLUCOCORTICOIDS TREATMENT FOR PATIENTS WITH LARGE HEMISPHERIC INFARCTION

Abstract Background and aims To evaluate effects of glucocorticoids treatment on outcomes in stroke patients with large hemispheric infarction (LHI). Methods This multicenter study included patients with LHI. Outcome measures included mortality and unfavorable functional outcomes (modified Rankin Scale score of 4 to 6) at 3 months. We explored effects of glucocorticoids treatment on outcomes, using inverse probability of treatment weighting to calculate weighted odds ratios (OR) and 95% confidence intervals (CIs). Confounders included in logistic regression were age, National Institutes of Health Stroke Scale (NIHSS) scores, thrombectomy, and use of hypertonic saline. Results We included 282 patients with LHI (median age 70, interquartile range [IQR] 58–78 years; admission NIHSS 15, IQR 12–19). Thirty-nine patients (13.8%) received glucocorticoids (31 on dexamethasone and 8 on methylprednisolone), administered intravenously with a median of 10 mg (IQR 10-15) of standardized dexamethasone once daily and initiated at a median of 86 h (IQR 39-146) since stroke onset for a median of 4 days (IQR 3-5). Of 275 patients completing 3-month follow-up, 106 (38.5%) died and 200 (72.7%) had unfavorable functional outcomes. Patients treated with glucocorticoids had lower risks of 3-month mortality (13.5% vs. 42.4%, weighted OR = 0.29, 95% CI 0.09-0.91, p = 0.03) compared to the control group. There was no significant difference in unfavorable functional outcomes between glucocorticoids and control groups (70.3% vs. 73.1%, weighted OR = 0.94, 95% CI 0.42-2.12, p = 0.89). Conclusions A short course of intravenous glucocorticoids might reduce risks of death at 3 months in patents with LHI. Conflict of interest Yanan Wang, Haoyang He, Xing Hua, Zhi Liu, Na Tang, Bijoy K. Menon, Craig S. Anderson, Ming Liu, Jiangang Duan and Simiao Wu have nothing to disclose.