Differences Between the “Chinese AMS Score” and the Lake Louise Score in the Diagnosis of Acute Mountain Sickness

Abstract

The Chinese AMS score (CAS) is used in clinical medicine and research to diagnosis acute mountain sickness (AMS). However, the Lake Louise Score (LLS) is the well-accepted standard for diagnosing AMS. The difference between the CAS and LLS questionnaires is that the CAS considers more nonspecific symptoms. The aim of the present study was to evaluate differences in AMS prevalence according to the LLS and CAS criteria. We surveyed 58 males who traveled from Chongqing (300 m) to Lhasa (3658 m) via the Qinghai-Tibet train. Cases of AMS were diagnosed using LLS and CAS questionnaires in a few railway stations at different evaluation areas along the road. We subsequently evaluated discrepancies in values related to the prevalence of AMS determined using the 2 types of questionnaires (CAS and LLS). The prevalence of CAS-diagnosed AMS indicated that the percentage of AMS cases among the 58 young men was 29.3% in Golmud, 60.3% in Tanggula, 63.8% in Lhasa, 22.4% on the first day after arrival in Lhasa, 27.6% on the second day, 24.1% on the third day, and 12.1% on the fourth day. The prevalence of LLS-diagnosed AMS in Golmud was 10.3%, 38% in Lhasa, and 6.9% on day 1, the prevalence in each station was lower than that as assessed by the CAS. Our experimental data indicate that AMS diagnoses ascertained using the CAS indicate a higher AMS prevalence than those ascertained using the LLS. Through statistical analysis, the CAS seems capable of effectively diagnosing AMS as validated by LLS (sensitivity 61.8%, specificity 92.7%).

Assessment of Acute Mountain Sickness: How to integrate the advantages of the Lake Louise Score and the Chinese AMS Score

“…However, due to the different symptoms and weights assigned, the incidence determined by the CAS assessment was higher than that by the LLS (59.3% vs 37.5%). This was consistent with previous studies [8,9]. The CAS had diagnostic accuracy for moderate and severe AMS similar to those of the LLS (16.9% vs 17.2%).…”

“…[25] [26] [27] [11] Some Chinese scholars have studied the difference between the LLS and CAS in de ning AMS. Chen et al [9] surveyed 339 males residing at sea level who travelled by train and car to 3200 m. Wu et al [8] surveyed 58 males who went by train and recorded the AMS incidence when they reached different altitude sites, ending at 3658 m. They found that CAS outcomes were in good agreement with LLS outcomes and can accurately diagnose AMS, suggesting that combining the LLS and the CAS in applications of clinical diagnosis can more objectively diagnose AMS than one scoring system alone.…”

Metabolite and protein shifts in mature erythrocyte under hypoxia

“…Untreated AMS can progress to high-altitude cerebral edema and high-altitude pulmonary edema (HAPE). 6 Approximately 140 million people, including about 79 million in Asia, live in high-altitude areas above 2,500 m. 7 These plateau residents suffer from chronic mountain sickness (CMS), a clinical syndrome that occurs in highland areas and is characterized by excessive erythrocytosis (EE) and severe hypoxemia. 8 The incidence of CMS increases with altitude and age.…”