Richalet et al reported physiological risk factors for severe high-altitude illness. This can help to identify a patient who may require more aggressive management. The authors are from multiple institutions in France.
Patient selection: person going to a high altitude
Outcome: severe high-altitude illness (SHAI)
Risk factors for severe high-altitude illness:
(1) previous history of severe high-altitude illness (adjusted OR 12.8)
(2) ascent > 400 meters per day (adjusted OR 5.9)
(3) history of migraine (adjusted OR 2.3)
(4) ventilatory response to hypoxia during exercise < 0.78 L/min/kg (adjusted OR 6.7)
(5) desaturation during exercise >= 22% (adjusted OR 2.5)
(6) failure to take acetazolamide (associated with a 44% reduction in relative risk of SHAI)
where:
• Items 5 and 6 indicate a disorder of chemosensitivity to hypoxia.
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