Incidence and Determinants of Acute Mountain Sickness in Mount Kinabalu, Malaysia

Abstract

Background: Acute mountain sickness (AMS) is the most common type of high-altitude sickness. The incidence of AMS varies by mountain location, trail characteristics, and study design. The lack of local epidemiology data has driven us to investigate the incidence and severity of AMS and its associated factors at Mount Kinabalu, Malaysia. Methods: A cohort study was conducted to collect data from climbers after days 1 (3272 m) and 2 (4095 m) of ascent. A self-administered questionnaire was used to explore climbers' demographic and climb characteristics, history of AMS, alcohol exposure, and AMS prevention measures. The Lake Louis score 2018 was used to assess the presence and severity of AMS (cutoff ‡3). Univariate and multivariable logistic regressions were performed to determine the factors associated with the development of AMS on day 2. Results: Data from 345 climbers were analyzed. The incidence of AMS was 23.9% (95% confidence interval [CI] 19.5%-28.7%) and 21.7% (95% CI 17.5%-26.3%) on days 1 and 2, respectively. The majority were mild cases. Experiencing AMS on day 1 (odds ratio [OR] = 12.88; 95% CI 6.71-24.75), alcohol consumption (OR = 3.73; 95% CI 1.66-8.39), receiving guide advice on day 1 (OR = 0.49; 95% CI 0.26-0.93), and age (OR = 0.96; 95% CI 0.93-0.99) were significant determinants of AMS at Mount Kinabalu. Gender, history of AMS, past exposure to high altitude, ascending time, water intake, acetazolamide use, physical fitness, pulse rate, and peripheral capillary oxygen saturation (SpO 2) were not associated with AMS at Mount Kinabalu. Conclusion: Future analysis with age strata is required to ascertain the association of age with AMS. Our research has signposted a strong call for collaborative efforts to improve the provision of hiking advice and discourage alcohol sales to mitigate the risk of AMS among Mount Kinabalu climbers.

Cardiovascular Indicators of Systemic Circulation and Acute Mountain Sickness: An Observational Cohort Study

“…This was consistent with our findings. Previous studies have also shown that alcohol use and obesity are associated with AMS (San Martin et al, 2017;Yang et al, 2020), whereas we found no difference in BMI and alcohol history between the two groups. Notably, a meta-analysis showed smoking to be neither a risk nor a protective factor, whereas we found that smoking was protective against AMS.…”

Does change in barometric pressure per given time at high altitude influence symptoms of acute mountain sickness on Mount Fuji? A pilot study

“…Rather, sleeping condition influenced the AMS. Study limitations should also be considered for the future studies, because LLS does not consider other effects, such as smoking [ 21 ] and alcohol intake [ 22 ], on the AMS risk.…”

Analisis Hubungan Tingkat Pengetahuan dengan Kejadian Acute Mountain (AMS) Sickness pada Mahasiswa Pecinta Alam

“…Kejadian AMS dipengaruhi dengan ketinggian gunung yang didaki, kecepatan berjalan, lamanya tinggal atau istirahat pada ketinggian tersebut, serta derajat aklmatisasi (Yang et al, 2020). Salah satu risiko high-altitute illness yang berat menunjukkan Hypoxic Ventilator Response (HVR) yang berakibat terjadinya takipnea karena penurunan kadar oksigen secara tiba-tiba dan psikologis pada kondisi hipoksia dipengaruhi oleh karakteristik penderita AMS.…”