ABSTRACT NUMBER: ESOC2026A435 THREE-YEAR SURVIVAL AFTER ISCHEMIC STROKE: AGE-STRATIFIED TRENDS IN SWEDEN, 2010–2021

Abstract Background and aims Prognostic estimates for post-stroke survival require continuous updating. The aim of this study was to assess 3-year survival in a national cohort and compare outcomes across age groups and over time. Methods In this registry-based study, patients with first-ever ischemic stroke recorded in the Swedish national stroke registry (Riksstroke) between 2010 and 2021 were followed for 3 years. Mortality data were obtained from the national Cause of Death Register. Cumulative incidence was analyzed using Kaplan–Meier methods, and log-rank tests were applied for temporal comparisons. A reference population matched (1:1) for sex, age, and region was used to relate changes in mortality to those in the general population. Patients were grouped by year of onset (2010–12, 2013–15, 2016–18, and 2019–21) and analyzed in four age strata (<65, 65–74, 75–84, and ≥85 years). Results The study included 174 290 patients with ischemic stroke (mean age 75.0 years; 48.1% women). At 3 years, 32.0% had died (95% CI: 31.8–32.2%), with 9.8% (95% CI: 9.7-10.0) and 13.7% (95%CI: 13.5-13.9) dying within 30 and 90 days, respectively. Mortality decreased significantly from 33.7% to 30.2% over the study period (p<0.001, figure 1), driven by reductions in the two oldest age groups. A decline in mortality was also observed in the reference population, though less pronounced than in the stroke cohort (−3.5% vs −2.4%, figure 1). Conclusions There is a trend toward lower mortality after ischemic stroke between 2010 and 2021, particularly among the oldest patients. Conflict of interest Joachim Ögren and Anna-Lotta Irewall: nothing to disclose Figure 1 - belongs to Results