Lawrence James S, Reid Stephen A
North Sydney Sports Medicine Centre, St. Leonards, Australia (Dr Lawrence).
Sports Medicine Practice, Hobart, Australia (Dr Reid).
Wilderness Environ Med. 2016 Mar;27(1):78-84. doi: 10.1016/j.wem.2015.11.011.
The aims of this study were to assess incidence of acute mountain sickness (AMS) and summit success on a 6-day ascent profile of Mt. Kilimanjaro and evaluate potential risk factors for these outcomes.
All trekkers through a single Australian tour company between August 2012 and July 2014 were included. Participants ascended via the Rongai route and attempted the summit on day 6. Daily assessments were made using the self-reported Lake Louise score (LLS) questionnaire. Two different AMS diagnostic criteria (LLS ≥ 3 and LLS ≥ 5) were used for data analysis. Risk factors for development of AMS and summit success were analyzed.
Over the 24-month period a total of 175 participants undertook the trek. Incidence of AMS was 52.6% (LLS ≥ 3) and 22.9% (LLS ≥ 5). Summit success was 88%. Age, sex, body mass index, and acetazolamide use were not associated with risk of AMS development. Age ≥ 40 years (P = .0002) and female sex (P = .0004) were both significantly associated with reduced summit success rate.
Our cohort found a lower incidence of AMS and better summit success on a 6-day ascent of Mt Kilimanjaro than previously described in other groups on 4- and 5-day ascents. Female sex and age ≥ 40 years both predicted failure to summit, but did not increase risk of developing AMS. AMS is a common cause of morbidity on Mt. Kilimanjaro, and although the risk can be mitigated by a slower ascent, there is an ongoing need for education of individual trekkers, tour companies, and local authorities.
本研究旨在评估乞力马扎罗山6日攀登过程中急性高原病（AMS）的发病率和登顶成功率，并评估这些结果的潜在风险因素。
纳入2012年8月至2014年7月期间通过一家澳大利亚旅游公司的所有徒步旅行者。参与者经荣盖路线攀登，并在第6天尝试登顶。每天使用自我报告的路易斯湖评分（LLS）问卷进行评估。数据分析采用两种不同的AMS诊断标准（LLS≥3和LLS≥5）。分析了AMS发生和登顶成功的风险因素。
在24个月期间，共有175名参与者进行了此次徒步旅行。AMS的发病率为52.6%（LLS≥3）和22.9%（LLS≥5）。登顶成功率为88%。年龄、性别、体重指数和使用乙酰唑胺与AMS发生风险无关。年龄≥40岁（P = 0.0002）和女性（P = 0.0004）均与登顶成功率降低显著相关。
我们的队列研究发现，乞力马扎罗山6日攀登的AMS发病率低于此前其他组4日和5日攀登的报道，登顶成功率更高。女性和年龄≥40岁均预示登顶失败，但并未增加发生AMS的风险。AMS是乞力马扎罗山发病的常见原因，尽管可以通过较慢的攀登速度降低风险，但仍需要持续对个体徒步旅行者、旅游公司和地方当局进行教育。
