Comparing questionnaires for the assessment of acute mountain sickness.

Exposure to high altitude in nonacclimatized subjects may lead to acute mountain sickness (AMS). AMS is a syndrome characterized by headache accompanied by one or more other symptoms, such as light-headedness, dizziness, loss of appetite, nausea, vomiting, fatigue, lassitude, and trouble sleeping. Assessing the presence and degree of AMS can be done using self-administered questionnaires like the Lake Louise Questionnaire (LLQ) and the Environmental Symptoms Questionnaire-III (ESQ-III). We compared LLQ and ESQ-III in 266 trekkers of different nationalities trekking over a 5400-m-high pass to assess if the two questionnaires identify the same population as suffering from AMS and to see whether using English questionnaires poses problems for nonnative English-speaking persons. The use of English questionnaires by nonnative English speakers influenced the outcome for some nationalities. For criterion scores yielding similar prevalence of AMS, ESQ-III labeled 20% of cases differently (AMS or no AMS) when compared to LLQ. Correlations between similar individual questions of ESQ-III and LLQ were variable, and there was considerable scatter between ESQ-III and LLQ scores. In conclusion, English questionnaires may pose problems in some international settings, and ESQ-III and LLQ may identify different populations as suffering from AMS.

Awareness, prevalence, medication use, and risk factors of acute mountain sickness in tourists trekking around the Annapurnas in Nepal: a 12-year follow-up.

Acute altitude exposure may lead to acute mountain sickness (AMS). Increased awareness of altitude-related health hazards in trekkers may accompany a decrease in AMS prevalence. We compared awareness and AMS prevalence in trekkers in two cohorts on an altitude trek up to 5400 m and assessed risk factors for AMS by repeating an observational cohort study 12 yr after an initial study. Questionnaires in English were distributed to two cohorts of 500 trekkers in 1986 and 1998. All trekkers over a several day period were asked to participate. Average participation rate was 62% (71% in 1986 and 53% in 1998). We found an increase in AMS awareness in trekkers from 80% to 95%, a decrease in AMS prevalence from 43% to 29%, and significant slower climbing profiles. We found no relationship between AMS and smoking habits, body mass index, oral contraception intake, or training status. By contrast, age was a strong independent risk factor inversely related to AMS. Subjects over 55 yr were 2.6 times less likely to suffer from AMS than subjects under 25 yr. Self-medication, including acetazolamide and analgesics, had increased importantly from 17% to 56%, and contraception intake in women had increased from 19% to 32%. In conclusion, in 1998 as compared to 1986, trekkers were older, climbed more slowly, had better awareness of altitude illness, used more medication, and suffered less from AMS.