Rate of Ascent and Acute Mountain Sickness at High Altitude

Hsu, Tai Yi; Weng, Yi Ming; Chiu, Yu Hui; Li, Wen Cheng; Chen, Pang Yen; Wang, Shih Hao; Huang, Kuo Feng; Kao, Wei Fong; Chiu, Te Fa; Chen, Jih Chang

doi:10.1097/jsm.0000000000000098

Cited by 17 publications

(13 citation statements)

References 25 publications

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“…with and without AMS at Mount Kinabalu was diminutive (D = 10 minutes, p > 0.05). The AMS studies in several shortduration hikes-2 days 1 night or 3 days 2 nights hike at Jade Mountain, Jiaming Lake, and the Eastern Alps-have also reported similar findings (Mairer et al, 2009;Wang et al, 2010;Hsu et al, 2015). Conventionally, fast ascent is a known risk factor for AMS in multiday hikes (Hackett et al, 1976;Schneider et al, 2002), and guidelines have cautioned climbers to make slower ascent (<500 m per day) at an altitude >3000 m to allow for acclimatization (Luks et al, 2010;Imray et al, 2011;Bärtsch and Swenson, 2013).…”

Section: Figmentioning

confidence: 73%

“…The incidence of AMS in Mount Kinabalu was 23.9% (95% CI 19.5%–28.7%) on day 1 and 21.7% (95% CI 17.5%–26.3%) on day 2. The incidence of AMS at other locations of similar altitude and duration of the hike was 23% at Jiaming Lake, Taiwan (3350 m) (Hsu et al, 2015 ), 38% at the Eastern Alps (3454 m) (Mairer et al, 2009 ), 29% at Mount Fuji (3776 m) (Horiuchi et al, 2016 ), and 28%–36% at Jade Mountain (3952 m) (Kao et al, 2002 ; Wang et al, 2010 ). While the incidence at Mount Kinabalu was lower, significant differences cannot be established due to the lack of 95% CI reported in other studies.…”

Section: Discussionmentioning

confidence: 99%

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

Yang¹,

Ibrahim

Jenarun

et al. 2020

High Altitude Medicine & Biology

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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.

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Section: Figmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 99%

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

Yang¹,

Ibrahim

Jenarun

et al. 2020

High Altitude Medicine & Biology

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“…The highest overall prevalence of AMS was 77.9%, and the lowest was 16.6% [4, 22]. The maximal single-study prevalence rates for AMS in women and men were 88.6 and 69.0%, respectively, whereas the minimal values in women and men were 14.3 and 15.8%, respectively [4, 22, 32]. Fifteen studies reported that women had a higher prevalence of AMS than men in the same experiment.…”

Section: Resultsmentioning

confidence: 99%

Sex-based differences in the prevalence of acute mountain sickness: a meta-analysis

Hou

Tan³

et al. 2019

Military Med Res

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BackgroundWhen lowlanders rapidly ascend to altitudes > 2500 m, they may develop acute mountain sickness (AMS). The individual susceptibility, ascending velocity, time spent at altitude, activity levels and altitude reached are considered risk factors for AMS. However, it is not clear whether sex is a risk factor. The results have been inconclusive. We conducted a meta-analysis to test whether there were sex-based differences in the prevalence of AMS using Lake Louise Scoring System.MethodsSystematic searches were performed in August 2019 in EMBASE, PubMed, and Web of Science for prospective studies with AMS data for men and women. The titles and abstracts were independently checked in the primary screening step, and the selected full-text articles were independently assessed in the secondary screening step by the two authors (YPH and JLW) based on pre-defined inclusion criteria. The meta-analysis was performed using by the STATA 14.1 software program. A random-effects model was employed.ResultsEighteen eligible prospective studies were included. A total of 7669 participants (2639 [34.4%] women) were tested. The results showed that there was a statistically significant higher prevalence rate of AMS in women than in men (RR = 1.24, 95%CI 1.09–1.41), regardless of age or race. Howerver, the heterogeneity was significant in the analysis (Tau2 = 0.0403, Chi2 = 50.15, df = 17; I2 = 66.1%, P = 0.000), it was main caused by different numbers of subjects among the studies (coefficient = − 2.17, P = 0.049). Besides, the results showed that there was no evidence of significant publication bias in the combined studies on the basis of Egger’s test (bias coefficient = 1.48, P = 0.052) and Begg’s test (P = 0.130).ConclusionsAccording to this study, the statistically significant finding emerging from this study was that women have a higher prevalence of AMS. However, the authors could not exclude studies where patients were on acetazolamide. Our analysis provided a direction for future studies of the relationship of sex and the risk of AMS, such as the pathological mechanism and prevention research.

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“…Finally, there were certain risk factors that we were unable to take into account; for example, history of migraine headache (a risk factor for AMS in other studies) 22 or rapidity of ascent (all of the workers studied travel up to the site in the same commuting arrangement). 23…”

Section: Limitationsmentioning

confidence: 99%

Smoking Increases the Risk of Acute Mountain Sickness

Vinnikov

Brimkulov

Blanc

2015

Wilderness & Environmental Medicine

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Rate of Ascent and Acute Mountain Sickness at High Altitude

Abstract: These findings indicate that factors other than ascent rate should be considered when trying to ameliorate the risk of AMS.

Cited by 17 publications

References 25 publications

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

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

Sex-based differences in the prevalence of acute mountain sickness: a meta-analysis

Smoking Increases the Risk of Acute Mountain Sickness

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