Abstract Number: Esoc2026a758 Trends in Hospital Discharges With a Diagnosis of Pediatric Stroke in Spain: A Nationwide Analysis

Abstract Background and aims Pediatric stroke leads to significant morbidity, yet nationwide longitudinal data regarding its epidemiology are scarce. We analyzed temporal trends in incidence, demographics, and in-hospital mortality rates in Spain. Methods A retrospective analysis (2005-2022) included Ischemic (IS) and Hemorrhagic Stroke (HS) in patients 28 days to 16 years, using data from the National Statistics Institute Hospital Morbidity Survey. Incidence rates were standardized to the European Standard Population. Results We identified 2,774 pediatric stroke cases (60.1% HS, 39.9% IS). Mean age was 7.1 years (SD 5.2), with 58.4% males. Mean annual incidence was 2.19 cases per 100,000 children (95% CI 2.07–2.31); higher for HS (1.32; 95% CI 1.24–1.40) than IS (0.87; 95% CI 0.80–0.94). Median length of stay was longer for HS (10 days; IQR 4–20) than IS (8 days; IQR 3–13) (P 0.001). Temporal trends showed rising incidence rates in females aged 5–9 (Rho = 0.72, P 0.001) and males 10–15 (Rho = 0.70, P = 0.001), contrasting with declines in the 0–4 age group (Males: Rho = -0.66, P = 0.003; Females: Rho = -0.62, P = 0.006). Overall in-hospital mortality was 6.4%, with a higher Case Fatality Rate for HS (8.15%) than IS (3.71%) (P 0.001). Conclusions Hemorrhagic stroke is the most frequent type of stroke in the Spanish pediatric population, accounting for the highest mortality and healthcare burden. A significant global shift in stroke epidemiology was identified, with rising incidence among adolescent males and school-aged females, and a marked reduction in stroke rates among children under 5 years of age. Conflict of interest Eduardo Mariño: Nothing to disclose. Figure 1 - belongs to Results