Abstract
BackgroundAcute mountain sickness (AMS) occurs in non-acclimatized people after an acute ascent to an altitude of 2,500 m or higher. The aim of this study was to examine the incidence and severity of AMS and associated symptoms in children.MethodsThe prospective observational study included 197 healthy, non-acclimatized 11 and 12-year-old children trekking the round-trip from the trailhead to the summit of Xue Mountain, Taiwan (2,179 m to 3,886 m) over 3 days. AMS was evaluated at Qika Hut (2,460 m) on Day 1, at Sanliujiu Hut on Day 2 (3,100 m), and at the same altitude (3,100 m) after reaching the summit on Day 3. We used the Lake Louise Score (LLS) to diagnose AMS and record daily AMS-associated symptoms. We gave acetazolamide to children with mild to moderate AMS. Dexamethasone was reserved for individuals suffering from severe AMS. Acetaminophen was administrated to children with headache, and metoclopramide for those with nausea or vomiting.ResultsThere were 197 subjects eligible for analysis. The overall incidence of AMS was 40.6%, which was higher in males and in subjects with a higher body mass index (BMI) (p < 0.05). The prevalence of AMS on Day 1 was 5.6%, which was significantly lower than that on Day 2 (29.4%) and Day 3 (23.4%). The mean LLS of all subjects was 1.77 ± 2.08. The overall incidence of severe AMS (LLS ≥ 5) was 12.5%. The mean LLS of the AMS group (3.02 ± 2.46) was significantly higher than that of the non-AMS group (0.92 ± 1.16, p < 0.001). Among the AMS group, the mean LLS was 1.00 ± 1.55 on Day 1, 4.09 ± 1.97 on Day 2, and 3.98 ± 2.42 on Day 3. The most common symptom was sleep disturbance followed by dizziness, and headache. The prevalence of headache was 46.2% on Day 2 at 3,100 m, and 31.3% on Day 3 at the same altitude after climbing the summit (3,886 m). Males experienced significantly more headache and fatigue than females (p < 0.05). The LLS and prevalence of all AMS symptoms were significantly higher in the AMS than the non-AMS group (p < 0.05).ConclusionsThe AMS incidence among children trekking to Xue Mountain was 40.6%. AMS is common and mostly manifests as mild symptoms. Gender (male) and a higher BMI could be considered two independent risk factors of higher AMS incidence. Sleep disturbance is the most common symptom, and the lower prevalence of headache on Day 3 may be due to the effects of medication and/or acclimatization.
Highlights
Acute mountain sickness (AMS) often occurs in non-acclimatized people after an acute ascent to an altitude of 2,500 m or higher
The overall incidence of AMS was 40.6%, which was higher in males and in subjects with a higher body mass index (BMI) (p < 0.05)
The AMS incidence among children trekking to Xue Mountain was 40.6%
Summary
Acute mountain sickness (AMS) often occurs in non-acclimatized people after an acute ascent to an altitude of 2,500 m or higher. The reported incidence in children varies, and the susceptibility to AMS in this age group compared to adults is controversial [1,2,3]. Most AMS symptoms are mild; at altitudes above 3,000 m, there is a chance of developing high-altitude cerebral edema (HACE) and high-altitude pulmonary edema (HAPE). In previous reports on adults, HACE usually develops after at least 2 days at altitudes above 4,000 m, and the incidence is estimated to be 0.5–1.0% at 4,000–5,000 m. Reports of HAPE and HACE in children are rare, and are usually individual cases. Children who have an upper respiratory infection tend to have a greater chance of developing AMS, and the risk of HAPE, and occasionally HACE, increases. The aim of this study was to examine the incidence and severity of AMS and associated symptoms in children
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call