Pulse Brain · Growing Health Evidence Index
Tier 3 — Observational / field trialPeer-reviewed

Physiological responses during ascent to high altitude and the incidence of acute mountain sickness

Alexandra Cobb, Denny Levett, Kay Mitchell, W Aveling, Daniel Hurlbut, Edward T. Gilbert-Kawai, P. J. Hennis, Monty Mythen, Michael P. W. Grocott, Daniel Martín, Caudwell Xtreme Everest, Xtreme Everest 2009, Xtreme Everest 2 investigators, Vineet Ahuja, Golnar Aref-Adib, Robert Burnham, Alexandra Chisholm, Kieran Clarke, David Coates, Matthew Coates, Derek G. Cook, Mark Cox, S Dhillon, C Dougall, Pat Doyle, Pamela W. Duncan, Mark Edsell, Laura Edwards, Lauren Evans, Peter Gardiner, Michael P. W. Grocott, P Gunning, Nicholas Hart, Jane Harrington, John Julian Harvey, C Holloway, Diantha B. Howard, David Hurlbut, Chris Imray, Can İnce, Jildou van der Kaaij, Maryam Khosravi, Nicky Kolfschoten, D Levett, H Luery, Andrew M. Luks, Daniel Martín, Roger McMorrow, Paula Meale, Kay Mitchell, Hugh Montgomery, Gareth J. Morgan, J Morgan, Andrew J. Murray, M Mythen, Stanton Newman, Michael O’Dwyer, James W. Pate, Timothy Plant, Matiram Pun, Paul Richards, Alan Richardson, George W. Rodway, John B. Simpson, Catherine Stroud, M Stroud, J Stygal, Barbara Symons, Piotr Szawarski, A Van Tulleken, Chris van Tulleken, André Vercueil, Liesl Wandrag, Mark H. Wilson, Jeremy S. Windsor, B Basnyat, Caroline S. Clarke, Thomas F. Hornbein, James S. Milledge, James A. West, Sabu Abraham, Tom Adams, W Anseeuw, Rónan Astin, B Basnyat, Oliver Burdall, Janet T. Carroll, Alistair R.M. Cobb, Jonny Coppel, Orestes Couppis, J. H. Court, Andrew F. Cumpstey, Thomas Davies, S Dhillon, Norman G. Diamond, C Dougall, T Geliot, Edward T. Gilbert-Kawai, Grace Gilbert-Kawai, Erich Gnaiger, Michael P. W. Grocott, C Haldane

Physiological Reports · 2021

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Summary

This study examined physiological responses to high-altitude ascent and evaluated predictive factors for acute mountain sickness. Lower step-test performance and lack of previous exposure to altitudes exceeding 5000 metres emerged as significant predictors of moderate-to-severe AMS. The authors propose the Xtreme Everest Step-Test as a simple, reproducible field screening tool, though they acknowledge its predictive precision remains relatively limited.

UK applicability

These findings may inform pre-expedition medical screening for UK mountaineers and high-altitude expedition organisers, potentially identifying individuals at higher risk of AMS before departure. However, the test's modest predictive precision may limit its clinical utility as a standalone decision-making tool in UK practice.

Key measures

Odds ratios (OR) for AMS development; step-test performance; altitude exposure history; physiological parameters during ascent

Outcomes reported

The study investigated physiological responses during ascent to high altitude and identified predictors of acute mountain sickness (AMS) development. Key outcomes included identification of the Xtreme Everest Step-Test as a field-based predictive tool for moderate-to-severe AMS.

Theme
Nutrition & health
Subject
Dietary patterns & chronic disease
Study type
Research
Study design
Observational cohort
Source type
Peer-reviewed study
Status
Published
Geography
International
System type
Human clinical
DOI
10.14814/phy2.14809
Catalogue ID
BFmowc2679-fdhksr

Topic tags

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