The Risk of Death to Trekkers and Hikers in the Mountains

Burtscher, Martin

doi:10.1001/jama.1995.03520300030031

Cited by 12 publications

(6 citation statements)

References 4 publications

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“…24,25 The rate of sudden death increases with altitude, in part because of the absence of medical facilities. [24][25][26][27] In addition, another cardiac morbidity, atrial fibrillation, can be worsened by rapid ascent to altitude 28 and is more often involved in strokes in patients living at high altitude. 29 Nevertheless, coronary artery disease remains the main cause of sudden cardiac death 30 as a result of reduced coronary vasodilatory reserve and increased cardiac work.…”

Section: Clinical Perspective On P 794mentioning

confidence: 99%

Electrocardiographic Changes During Exercise in Acute Hypoxia and Susceptibility to Severe High-Altitude Illnesses

et al. 2015

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Background-The goals of this study were to compare ECG at moderate exercise in normoxia and hypoxia at the same heart rate, to provide evidence of independent predictors of hypoxia-induced ECG changes, and to evaluate ECG risk factors of severe high-altitude illness. Methods and Results-A total of 456 subjects performed a 20-minute hypoxia exercise test with continuous recording of ECG and physiological measurements before a sojourn above 4000 m. Hypoxia did not induce any conduction disorder, arrhythmias, or change in QRS axis. The amplitude of the P wave in V 1 was lower in hypoxia than in normoxia. The amplitudes of the R, S, and T waves and the Sokolow index decreased in hypoxia. Under hypoxia, the amplitude of the ST segment decreased in II and V 6 and increased in V 1 , the ST slope rose in V 5 and V 6 , and the J point was lower in II, V 5 , and V 6 . Multivariate regression of hypoxic/normoxic ratios of electrophysiological parameters and clinical characteristics showed a correlation between the decrease in Sokolow index and T-wave amplitude in V 5 with desaturation at exercise. Trained status and low body mass index were associated with a smaller decrease in T-wave amplitude in V 5 and V 6 .Comparison of ECG between subjects suffering or not suffering from severe high-altitude illness failed to show any difference. Conclusions-During

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Section: Clinical Perspective On P 794mentioning

confidence: 99%

Electrocardiographic Changes During Exercise in Acute Hypoxia and Susceptibility to Severe High-Altitude Illnesses

et al. 2015

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“…Some of the estimates for mountaineering at lower elevation (Ferris, 1963;Christensen and Lacsina, 1999;Malcolm, 2001) lack accurate exposure data and have, thus, higher uncertainties. Quantitative risk estimates based on general participation in sports are available for mountaineering in England and Wales (Avery et al, 1990) as well as Austria (Burtscher, 1990(Burtscher, , 1996Burtscher and Nachbauer, 1999;Burtscher et al, 1993Burtscher et al, , 1994Burtscher et al, , 1995Burtscher et al, , 1997a. These risk estimates are not included in Table 1, as they are not based on detailed records of the number of exposed.…”

Section: Overall Risk Estimatesmentioning

confidence: 99%

“…in the different altitude ranges between 2000 and 6000 m, it was concluded by these authors that the main risks of trekking are not related primarily to altitude but to the hazardous terrain and to illness occurring in a remote area. In contrast, an obvious increase of mortality during trekking with altitude was mentioned by Burtscher et al (1995) and : 2.3 deaths per 10 6 exposure days for England and Wales (Avery et al, 1990), 5.7 per 10 6 exposure days for Austria (Burtscher et al, 1995), and 10.6 per 10 6 exposure days for Nepal (Shlim and Houstan, 1989). However, as mortality during trekking is affected by many other factors than altitude, concluded that these data are suggestive at best.…”

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confidence: 98%

Fatalities in High Altitude Mountaineering: A Review of Quantitative Risk Estimates

Weinbruch¹,

Nordby

2013

High Altitude Medicine & Biology

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Quantitative estimates for mortality in high altitude mountaineering are reviewed. Special emphasis is placed on the heterogeneity of the risk estimates and on confounding. Crude estimates for mortality are on the order of 1/1000 to 40/1000 persons above base camp, for both expedition members and high altitude porters. High altitude porters have mostly a lower risk than expedition members (risk ratio for all Nepalese peaks requiring an expedition permit: 0.73; 95 % confidence interval 0.59-0.89). The summit bid is generally the most dangerous part of an expedition for members, whereas most high altitude porters die during route preparation. On 8000 m peaks, the mortality during descent from summit varies between 4/1000 and 134/1000 summiteers (members plus porters). The risk estimates are confounded by human and environmental factors. Information on confounding by gender and age is contradictory and requires further work. There are indications for safety segregation of men and women, with women being more risk averse than men. Citizenship appears to be a significant confounder. Prior high altitude mountaineering experience in Nepal has no protective effect. Commercial expeditions in the Nepalese Himalayas have a lower mortality than traditional expeditions, though after controlling for confounding, the difference is not statistically significant. The overall mortality is increasing with increasing peak altitude for expedition members but not for high altitude porters. In the Nepalese Himalayas and in Alaska, a significant decrease of mortality with calendar year was observed. A few suggestions for further work are made at the end of the article.

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“…Interest in the basic fatality rates associated with highaltitude mountaineering has existed for quite some time (Pollard and Clarke 1988 ;Burtscher et al 1995 ;Salisbury and Hawley 2007 ;Firth et al 2008 ;Windsor et al 2009 ). Recently, some researchers, most notably Raymond Huey and Xavier Eguskitza, have begun testing whether factors such as elevation, gender, age, weather, or the use of bottled oxygen are associated with success or death on high-altitude peaks.…”

Section: Death Risks In the Mountaineering Literaturementioning

confidence: 99%

Is high-altitude mountaineering Russian roulette?

Cheng¹

2013

Journal of Quantitative Analysis in Sports

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Whether the nature of the risks associated with climbing high-altitude (8000 m) peaks is in some sense "controllable" is a longstanding debate in the mountaineering community. Well-known mountaineers David Roberts and Ed Viesturs explore this issue in their recent memoirs. Roberts views the primary risks as " objective " or uncontrollable, whereas Viesturs maintains that experience and attention to safety can make a significant difference. This study sheds light on the Roberts-Viesturs debate using a comprehensive dataset of climbing on Nepalese Himalayan peaks. To test whether the data is consistent with a constant failure rate model (Roberts) or a decreasing failure rate model (Viesturs), it draws on Total Time on Test (TTT) plots from the reliability engineering literature and applies graphical inference techniques to them.

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The Risk of Death to Trekkers and Hikers in the Mountains

Cited by 12 publications

References 4 publications

Electrocardiographic Changes During Exercise in Acute Hypoxia and Susceptibility to Severe High-Altitude Illnesses

Electrocardiographic Changes During Exercise in Acute Hypoxia and Susceptibility to Severe High-Altitude Illnesses

Fatalities in High Altitude Mountaineering: A Review of Quantitative Risk Estimates

Is high-altitude mountaineering Russian roulette?

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