ABSTRACT NUMBER: ESOC2026A1255 HEALTH AND SOCIAL CARE COSTS OF RECURRENT STROKE: LONG-TERM FOLLOW-UP OF A POPULATION-BASED COHORT

Abstract Background and aims Improved life-expectancy after TIA/stroke has increased the patient-years lived at risk of recurrent stroke. There are few reliable data on recurrence rates on current best medical treatment (BMT) or on the long-term impact on care costs. We aimed to quantify the long-term cost burden of recurrent stroke after an initial TIA or stroke. Methods In a UK population-based incidence cohort (04/2002–03/2020), all patients with first-in-study stroke/TIA were given guideline-based secondary prevention and followed to 5-years or prior death. Recurrent stroke was identified by face-to-face follow-up and other multiple overlapping methods. Data on health and residential care resource were supplemented by national record linkage and costed using English reference costs. The incremental effect of recurrent stroke was assessed using panel multivariable fixed-effects regression, adjusted by survival obtained through time varying covariate Cox-regression. Results Among 3,159 stroke and 2,007 TIA patients, 434(14%) and 236(12%) respectively experienced ≥1 recurrent stroke within 5-years. Without recurrent stroke, 5-year hospital costs averaged €17,233 (95%CI=16,443–17,982) after an initial stroke and €12,032 (11,212-12,913) after an initial TIA. Each recurrent stroke increased hospital costs by €6,124 (2,150-11,573;p<0.001) and €9,532 (3,765-14,752,p<0.001), respectively and total hospital/residential care costs by €13,235 (3,901–26,536;p<0.001) and €20,154 (6,633-32,487;p<0.001) respectively. Further analyses by TOAST subtype, stroke severity, age, high-risk TIA, and other characteristics will be presented. Conclusions The costs of recurrent stroke on current BMT remain substantial, highlighting the economic case for further investment in secondary prevention. Conflict of interest RL-F, LS and PMR have received unrestricted educational research grants from Bayer, NIHR - Oxford Biomedical Research Centre, and Wellcome Trust