Long-Term Prognosis of Spontaneous Intracerebral Hemorrhage on the Tibetan Plateau: A Prospective Cohort Study at 2 Hospitals

BACKGROUND: Patterns of intracerebral hemorrhage (ICH) and outcomes in Tibetans are poorly understood. We aimed to investigate the long-term outcomes of Tibetan ICH patients. METHODS: This prospective study involved a consecutive series of ICH patients admitted within 1 month of onset to West China Hospital (WCH) on the Chengdu Plain or People's Hospital of Garze (PHG) on the Tibetan Plateau between January 2013 and December 2013. Basic characteristics and functional outcomes were compared between PHG and WCH groups. RESULTS: Of the 843 cases included, 105 (12.5%) were from PHG and 738 (87.5%) were from WCH. Compared with patients from WCH, patients from PHG were older and had higher blood pressure on admission, and a greater proportion had hypertension (all P < 0.001). Among patients from PHG, the 1-year death rate was 30.5%, similar to that in WCH (P = 0.987), and the adjusted 3-month disability risk was 2.0-fold higher than for WCH patients, while the adjusted 1-year disability risk was 2.5-fold higher than for WCH patients (both P <= 0.05). The adjusted 3-month risk of disability/death was 2.1-fold higher in PHG patients than in WCH patients, while the adjusted 1-year risk was 2.4-fold higher (both P <= 0.05). CONCLUSIONS: Most cases of ICH on the Tibetan Plateau involve concomitant hypertension. Tibetan patients are at higher risk of disability or disability/death on follow-up than are patients from Chengdu Plain.