Spontaneous Intracerebral Hemorrhage in a Plateau Area: A Study Based on the Tibetan Population

Abstract

To reveal the characteristics of spontaneous intracerebral hemorrhage (sICH) in a plateau area based on the Tibetan population. Data of Tibetan and Han patients (control group) with sICH treated at our center from January 2013 to April 2017 were retrospectively reviewed. A total of 122 Tibetan and 927 Han patients were included. Compared with Han patients, Tibetan patients were older (54.7 ± 11.2 vs. 50.9 ± 18.3 years, P=0.027), exhibited higher male-to-female ratios (73.8% vs. 55.0%, P < 0.001), were more overweight (22.1% vs. 13.1%, P= 0.007) had more smokers (36.9% vs. 20.5%, P<0.001), had a higher concentration of hemoglobin (163.7 ± 17.6 vs. 134.8 ± 20.2 g/L, P<0.001), and included a higher number of patients with hypertension (83.6% vs. 60.5%, P<0.001), diabetes mellitus (19.2% vs. 9.3%, P= 0.002), and prior hemorrhagic stroke (9.0% vs. 2.0%, P < 0.001). Tibetan patients also experienced more brainstem hemorrhage (11.5% vs. 5.1%, P= 0.039) in the infratentorial region and had a higher risk of in-hospital complications resulting from hematoma enlargement (20.5% vs. 10.4%, P= 0.002) and cerebral infarction (59.0% vs. 9.7%, P< 0.001). During a 6-month follow-up period, they had higher rates of unfavorable outcomes and case mortality (P < 0.05). A multivariable analysis adjusted for confounding factors revealed that the Tibetan race was positively associated with unfavorable clinical outcomes in sICH patients (P < 0.05). Tibetan sICH patients from the plateau area presented unique characteristics in their baseline measurements, incidence of comorbidities, hematoma location, risk of in-hospital complications, and clinical outcomes compared with Han patients. The Tibetan race was positively associated with unfavorable 6-month outcomes in ICH patients.