title: Mortality on Mount Everest, 1921-2006: descriptive study.
abstract: OBJECTIVE
  To examine patterns of mortality among climbers on Mount Everest over an 86 year period.
  
  
  METHODS
  Descriptive study.
  
  
  METHODS
  Climbing expeditions to Mount Everest, 1921-2006.
  
  
  METHODS
  14,138 mountaineers; 8030 climbers and 6108 sherpas.
  
  
  METHODS
  Circumstances of deaths.
  
  
  RESULTS
  The mortality rate among mountaineers above base camp was 1.3%. Deaths could be classified as involving trauma (objective hazards or falls, n=113), as non-traumatic (high altitude illness, hypothermia, or sudden death, n=52), or as a disappearance (body never found, n=27). During the spring climbing seasons from 1982 to 2006, 82.3% of deaths of climbers occurred during an attempt at reaching the summit. The death rate during all descents via standard routes was higher for climbers than for sherpas (2.7% (43/1585) v 0.4% (5/1231), P<0.001; all mountaineers 1.9%). Of 94 mountaineers who died after climbing above 8000 m, 53 (56%) died during descent from the summit, 16 (17%) after turning back, 9 (10%) during the ascent, 4 (5%) before leaving the final camp, and for 12 (13%) the stage of the summit bid was unknown. The median time to reach the summit via standard routes was earlier for survivors than for non-survivors (0900-0959 v 1300-1359, P<0.001). Profound fatigue (n=34), cognitive changes (n=21), and ataxia (n=12) were the commonest symptoms reported in non-survivors, whereas respiratory distress (n=5), headache (n=0), and nausea or vomiting (n=3) were rarely described.
  
  
  CONCLUSIONS
  Debilitating symptoms consistent with high altitude cerebral oedema commonly present during descent from the summit of Mount Everest. Profound fatigue and late times in reaching the summit are early features associated with subsequent death.
authors.affiliation: Department of Anesthesia and Critical Care, Massachusetts General Hospital, Boston, MA 02114, USA. pfirth@partners.org
authors.forename: Paul G
authors.initials: PG
authors.lastname: Firth
authors.forename: Hui
authors.initials: H
authors.lastname: Zheng
authors.forename: Jeremy S
authors.initials: JS
authors.lastname: Windsor
authors.forename: Andrew I
authors.initials: AI
authors.lastname: Sutherland
authors.forename: Christopher H
authors.initials: CH
authors.lastname: Imray
authors.forename: G W K
authors.initials: GW
authors.lastname: Moore
authors.forename: John L
authors.initials: JL
authors.lastname: Semple
authors.forename: Robert C
authors.initials: RC
authors.lastname: Roach
authors.forename: Richard A
authors.initials: RA
authors.lastname: Salisbury
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000368:Aged; D000532:Altitude Sickness / Q000401:mortality / Q000628:therapy; D002423:Cause of Death; D002648:Child; D003645:Death, Sudden / Q000453:epidemiology; D005260:Female; D006801:Humans; D007035:Hypothermia / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009051:Mountaineering / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014887:Weather