Abstract DP236: Temporal Trends in Stroke After Cardiac Surgery: 10-Year Analysis of 137,720 Patients from the Australian and New Zealand Society of Cardiothoracic Surgery (ANZSCTS) Adult Cardiac Surgical Database.

Introduction: Permanent stroke after cardiac surgery remains a major source of morbidity and mortality. Large-scale, contemporary data describing long-term incidence, risk factors, and outcomes in Australia and New Zealand are limited. This study examined the incidence and evolving risk profiles over the past decade using a comprehensive registry. Methods: Adults undergoing cardiac surgery (2014-2023) in the Australian and New Zealand Society of Cardiothoracic Surgery (ANZSCTS) Adult Cardiac Surgical Database were analysed. This bi-national clinical registry prospectively captures preoperative, intraoperative, and outcome data from >95% of cardiac surgeries in Australian and New Zealand. Permanent stroke was defined as a new neurological deficit persisting >72 hours. Trends were tested with the Cochran-Armitage test; multivariable logistic regression identified independent predictors; calendar year was excluded as a covariate to allow mechanistic interpretation of changes in predictor prevalence over time. Results: Among 137,720 patients, permanent stroke occurred in 2,104 patients (1.53%). Incidence increased from 1.13% in 2014 to 1.43% in 2023 (+27% relative change, p-trend