Abstract
Introduction
Acute mountain sickness (AMS) is a potentially life threatening complication of high altitude trekking. Several ascent profiles of Mount Kilimanjaro have been criticized for rapid ascent allowing little acclimatization time. The 7 day Lemosho route is one of the longest treks, allowing 2 days for acclimatization (day 3 & 4) and more time for rest which should improve the success rate of trekkers reaching the summit as well as decreasing the incidence of potentially fatal complications of AMS such as high altitude cerebral edema (HACE).
Objective
To evaluate symptom profiles of trekkers on Lemosho route to determine whether this route enhances acclimatization.
Methods
Daily measurement of oxygen saturation, heart rate, and Lake Louise Symptom Score (LLSS), plus clinical assessment score (CAS) recorded days 1–4, summit day for 25 subjects.
Results
Median LLSS + CAS day 1 = 0.56, incidence of AMS 4% ; median LLSS + CAS day 2 = 2.24, incidence of AMS 40%; median LLSS + CAS day 3 = 1.72, incidence of AMS 36%; median LLSS + CAS day 5 = 1.84 incidence of AMS 24%; median LLSS + CAS summit day = 2.4 incidence of AMS 40%. Incidence of AMS/HAPE in smokers (12%; n = 3) = 0; incidence of AMS/HAPE in non-smokers (88%; n = 24) = 48% (n = 12); incidence of AMS/HAPE without acetazolamide (24%; n = 6) = 8% (n = 2); incidence of AMS/HAPE with acetazolamide (76%; n = 19) = 10.
Conclusions
Incidence of AMS has been reported to range between 47 and 75% on Mount Kilimanjaro. Our results show a significantly lower rate with symptom scores and heart rate highest at day 2 but improved following the subsequent acclimatization day demonstrating benefits of the longer route and the value of time to acclimatize.