ABSTRACT NUMBER: ESOC2026LB31 AGE-RELATED DISPARITIES IN STROKE PRESENTATION AND OUTCOME IN A WEST AFRICAN COHORT: COMPARISON WITH INTERNATIONAL PRACTICE

Abstract

Abstract Background and aims In sub-Saharan Africa, data describing age-specific stroke profiles and their alignment with international standards remain scarce. We aimed to compare stroke characteristics between younger and older adults in Senegal and to explicitly contrast our findings with international stroke care benchmarks. Methods We performed a retrospective hospital-based study of 130 consecutive stroke patients admitted to a tertiary center in Senegal. Patients were categorized as <55 years (n=42) or ≥55 years (n=88). Demographics, vascular risk factors, NIHSS at admission, stroke subtype, neuroimaging patterns, etiology, in-hospital complications, length of stay, and outcomes at discharge were analyzed. Results Compared with international registries reporting early admission within the first hours after symptom onset, median arrival time in our cohort was markedly delayed at approximately 60 hours. Mean age was 59.41+/-16.2 years old. Hemorrhagic stroke was significantly more frequent in younger patients (35.5% vs 17.0%, p=0.018). Older patients showed higher stroke severity, greater burden of cardioembolic etiology (34% vs 6.3%), and more in-hospital complications (62.8% vs 40%). Length of hospital stay was prolonged in both age groups, and unfavorable functional outcome at discharge (mRS ≥3) exceeded 60%, with in-hospital mortality around 24%, substantially higher than rates reported in high-income settings. Conclusions This West African cohort demonstrates differences from international stroke care standards, including extreme delays in presentation, a high burden of hemorrhagic stroke among younger adults, and poor functional outcomes. These findings highlight inequities in stroke systems of care and support urgent implementation of context-adapted stroke pathways and prevention strategies in low-resource settings. Conflict of interest