Abstract
Introduction
Sickle-cell trait (SCT) has been associated with an increased risk of injury and death among otherwise fit athletes training at both lower elevations and elevations greater than 5000 feet. Military population rates of injury have been consistently lower than civilian sectors in previous studies. Nevertheless, no large-scale studies of this type have looked at altitude and the effects of hydration on SCT-related complications. The military uses an aggressive hydration and work/rest protocol for all soldiers.
Objective
The investigators hypothesized that hydration and work/rest protocols may have led to lower rates of injury in soldiers with SCT exposed to altitude.
Methods
We conducted a retrospective review of a 2800 soldier cohort using blinded data of injuries occurring in participants with pre-identified SCT during a series of 28-day Marine Mountain Warfare training events conducted in Bridgeport, CA from May 2010–Feb 2012. All soldiers with SCT enrolled in the course were included in the study and their injury patterns followed. We compared their patterns with those of the non-SCT population.
Results
Out of the 2800 soldiers, 25 had SCT, but only 1 of the SCT group had an altitude-related complication (acute mountain sickness). Surprisingly, despite a reported clear predilection for complications secondary to SCT, altitude-specific illnesses were rare and only occurred once out of 25 participants (4%). The rate of injuries was much lower than previous civilian studies. There were no deaths in either the study group or the control group.
Conclusions
Medical providers must be prepared to recognize possible SCT-related complications at elevations above 5–10,000 feet, but also recognize that it may be far more likely that their soldiers with SCT will more likely have a wide range of routine illnesses and injuries that are not altitude related.