BACKGROUND: Trekking in Nepal is a popular adventure travel activity involving more than 80,000 people of all ages annually. This study focuses on the demographic characteristics and clinical course of altitude illness patients evacuated to Kathmandu and estimates the rates of evacuation in different regions of Nepal. METHODS: During the years 1999 to 2006, all patients who presented with altitude illness to the CIWEC clinic in Kathmandu were evaluated and included in the study if the final diagnosis was compatible with high-altitude cerebral edema (HACE), high-altitude pulmonary edema (HAPE), or acute mountain sickness (AMS). Altitude illness-related deaths were reported according to death certificates issued by selected embassies in Kathmandu. RESULTS: A total of 406 patients were evaluated, among them 327 retrospectively and 79 prospectively. HACE was diagnosed in 21%, HAPE in 34%, combined HAPE and HACE in 27%, and AMS in 18%. Mean patient age was older than trekker controls (44 +/- 13.5 vs 38.6 +/- 13.9 y, p < 0.0001). Everest region trekkers were more likely to be evacuated for altitude illness than trekkers in other regions. The estimated incidence of altitude illness-related death was 7.7/100,000 trekkers. Most altitude illness symptoms resolved completely within 2 days of evacuation. CONCLUSIONS: Altitude illness that results in evacuation occurs more commonly among trekkers in the Everest region and among older trekkers. The outcome of all persons evacuated for altitude illness was uniformly good, and the rate of recovery was rapid. However, the incidence of altitude illness-related death continued to rise over past decade.
BACKGROUND: Trekking in Nepal is a popular adventure travel activity involving more than 80,000 people of all ages annually. This study focuses on the demographic characteristics and clinical course of altitude illness patients evacuated to Kathmandu and estimates the rates of evacuation in different regions of Nepal. METHODS: During the years 1999 to 2006, all patients who presented with altitude illness to the CIWEC clinic in Kathmandu were evaluated and included in the study if the final diagnosis was compatible with high-altitude cerebral edema (HACE), high-altitude pulmonary edema (HAPE), or acute mountain sickness (AMS). Altitude illness-related deaths were reported according to death certificates issued by selected embassies in Kathmandu. RESULTS: A total of 406 patients were evaluated, among them 327 retrospectively and 79 prospectively. HACE was diagnosed in 21%, HAPE in 34%, combined HAPE and HACE in 27%, and AMS in 18%. Mean patient age was older than trekker controls (44 +/- 13.5 vs 38.6 +/- 13.9 y, p < 0.0001). Everest region trekkers were more likely to be evacuated for altitude illness than trekkers in other regions. The estimated incidence of altitude illness-related death was 7.7/100,000 trekkers. Most altitude illness symptoms resolved completely within 2 days of evacuation. CONCLUSIONS: Altitude illness that results in evacuation occurs more commonly among trekkers in the Everest region and among older trekkers. The outcome of all persons evacuated for altitude illness was uniformly good, and the rate of recovery was rapid. However, the incidence of altitude illness-related death continued to rise over past decade.
Authors: Alyssa Huff; Trevor A Day; Mason English; Mitchell D Reed; Shaelynn Zouboules; Gurkarn Saran; Jack K Leacy; Carli Mann; Joel D B Peltonen; Ken D O'Halloran; Mingma T Sherpa; Teresa Pitts Journal: Respir Physiol Neurobiol Date: 2018-06-18 Impact factor: 1.931
Authors: Kevin R Barker; Andrea L Conroy; Michael Hawkes; Holly Murphy; Prativa Pandey; Kevin C Kain Journal: J Travel Med Date: 2016-03-16 Impact factor: 8.490
Authors: Christopher J Boos; Malcolm Bass; John P O'Hara; Emma Vincent; Adrian Mellor; Luke Sevier; Humayra Abdul-Razakq; Mark Cooke; Matt Barlow; David R Woods Journal: PLoS One Date: 2018-06-21 Impact factor: 3.240
Authors: Hannes Gatterer; Martin Niedermeier; Elena Pocecco; Anika Frühauf; Martin Faulhaber; Verena Menz; Johannes Burtscher; Markus Posch; Gerhard Ruedl; Martin Burtscher Journal: Int J Environ Res Public Health Date: 2019-10-15 Impact factor: 3.390