title: Risk Determinants of Acute Mountain Sickness and Summit Success on a 6-Day Ascent of Mount Kilimanjaro (5895 m).
abstract: OBJECTIVE
  The aims of this study were to assess incidence of acute mountain sickness (AMS) and summit success on a 6-day ascent profile of Mt. Kilimanjaro and evaluate potential risk factors for these outcomes.
  
  
  METHODS
  All trekkers through a single Australian tour company between August 2012 and July 2014 were included. Participants ascended via the Rongai route and attempted the summit on day 6. Daily assessments were made using the self-reported Lake Louise score (LLS) questionnaire. Two different AMS diagnostic criteria (LLS ≥ 3 and LLS ≥ 5) were used for data analysis. Risk factors for development of AMS and summit success were analyzed.
  
  
  RESULTS
  Over the 24-month period a total of 175 participants undertook the trek. Incidence of AMS was 52.6% (LLS ≥ 3) and 22.9% (LLS ≥ 5). Summit success was 88%. Age, sex, body mass index, and acetazolamide use were not associated with risk of AMS development. Age ≥ 40 years (P = .0002) and female sex (P = .0004) were both significantly associated with reduced summit success rate.
  
  
  CONCLUSIONS
  Our cohort found a lower incidence of AMS and better summit success on a 6-day ascent of Mt Kilimanjaro than previously described in other groups on 4- and 5-day ascents. Female sex and age ≥ 40 years both predicted failure to summit, but did not increase risk of developing AMS. AMS is a common cause of morbidity on Mt. Kilimanjaro, and although the risk can be mitigated by a slower ascent, there is an ongoing need for education of individual trekkers, tour companies, and local authorities.
authors.affiliation: North Sydney Sports Medicine Centre, St. Leonards, Australia (Dr Lawrence). Electronic address: drjameslawrence@gmail.com.
authors.forename: James S
authors.initials: JS
authors.lastname: Lawrence
authors.affiliation: Sports Medicine Practice, Hobart, Australia (Dr Reid).
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Reid
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000532:Altitude Sickness / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009051:Mountaineering / Q000706:statistics & numerical data*; D012307:Risk Factors; D012621:Seasons; D013636:Tanzania / Q000453:epidemiology; D055815:Young Adult
keywords: altitude sickness; epidemiology; mountain sickness