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Impact of Study Design on Reported Incidences of Acute Mountain Sickness: A Systematic Review.

Abstract：

AIMS:Published incidences of acute mountain sickness (AMS) vary widely. Reasons for this variation, and predictive factors of AMS, are not well understood. We aimed to identify predictive factors that are associated with the occurrence of AMS, and to test the hypothesis that study design is an independent predictive factor of AMS incidence. We did a systematic search (Medline, bibliographies) for relevant articles in English or French, up to April 28, 2013. Studies of any design reporting on AMS incidence in humans without prophylaxis were selected. Data on incidence and potential predictive factors were extracted by two reviewers and crosschecked by four reviewers. Associations between predictive factors and AMS incidence were sought through bivariate and multivariate analyses for different study designs separately. Association between AMS incidence and study design was assessed using multiple linear regression. RESULTS:We extracted data from 53,603 subjects from 34 randomized controlled trials, 44 cohort studies, and 33 cross-sectional studies. In randomized trials, the median of AMS incidences without prophylaxis was 60% (range, 16%-100%); mode of ascent and population were significantly associated with AMS incidence. In cohort studies, the median of AMS incidences was 51% (0%-100%); geographical location was significantly associated with AMS incidence. In cross-sectional studies, the median of AMS incidences was 32% (0%-68%); mode of ascent and maximum altitude were significantly associated with AMS incidence. In a multivariate analysis, study design (p=0.012), mode of ascent (p=0.003), maximum altitude (p<0.001), population (p=0.002), and geographical location (p<0.001) were significantly associated with AMS incidence. Age, sex, speed of ascent, duration of exposure, or history of AMS were inconsistently reported and therefore not further analyzed. CONCLUSIONS:Reported incidences and identifiable predictive factors of AMS depend on study design.

journal_name

High Alt Med Biol

journal_title

High altitude medicine & biology

authors

Waeber B,Kayser B,Dumont L,Lysakowski C,Tramèr MR,Elia N

doi

10.1089/ham.2015.0022

subject

Has Abstract

pub_date

2015-09-01 00:00:00

pages

204-15

issue

eissn

1527-0297

issn

1557-8682

journal_volume

pub_type

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Impact of Study Design on Reported Incidences of Acute Mountain Sickness: A Systematic Review.