HIGH ALTITUDE ILLNESS: EXPERIENCE OF ONE YEAR

High Altitude Illness

Abstract

Objectives of this study was to analyze symptoms of altitude illness commonly necessitating evacuation of patients from high altitude to the base hospitals in Siachin area by simple clinical screening. This was a prospective observational. Place and duration of study was Northern areas of Pakistan. This study was carried out at altitudes of 3633 meters (GOMA) and 2833 meters (Siksa) from Oct 2003 till Oct 2004. One hundred and thirty eight patients of altitude illness were studied, who were evacuated from altitude above 4000 meters. Out of 138 cases, 103 (74.6%) patients suffered from acute mountain sickness (AMS), while 21(15.2%) patients developed high altitude pulmonary edema (HAPE) and 14 (10.1%) patients developed high altitude cerebral edema (HACE), of which 3 patients were having concomitant HAPE. The most common symptom combination was headache and vomiting which was the presenting feature in 53(38.4%) patients, followed by headache, loss of appetite and insomnia, in 41(29.7) patients. Headache was the most common single symptom present in about 120(86.96%) patients that required evacuation. The next common symptom was vomiting that was found in 51(36.96%) patients while shortness of breath was present in 33(23.91%) patients. We conclude that headache is the most common presenting symptom in all the patients of AMS. Therefore, headache at high altitude should be taken seriously, if does not respond to common medication, then patient should be evacuated to a lower altitude. The incidence of AMS, HAPE, and HACE may be reduced by improving the physical fitness of mountaineers and observing the protocol of acclimatization.