title: Results of a Prospective Observational Study on Mountaineering Emergencies in Western Alps: Mind Your Head.
abstract: Brustia, Raffaele, Giulia Enrione, Bruna Catuzzo, Luca Cavoretto, Massimo Pesenti Compagnoni, Enrico Visetti, Emmanuel Cauchy, Stefanie Ziegler, and Guido Giardini. Results of a prospective observational study on mountaineering emergencies in Western Alps: mind your head. High Alt Med Biol. 17:116-121, 2016.-
  
  
  BACKGROUND
  In the northern Italian district Valle d'Aosta district during winter and summer season the population can increase up to 170% of the resident population. A prospective monocentric observational registry was held to obtain a precise picture of seasonal mountain-related medical and traumatic major events.
  
  
  METHODS
  From 1st January 2012 to 31st December 2013 all patients admitted to the Aosta Regional Hospital Emergency Room for any event occurred above 2500 m were screened: all those affected by High Altitude Illness, Acute Illness in High Altitude, Trauma, or Cold disease were prospectively included. Activity incidence rate is expressed as the occurrence of mountain-related events per 1000 hours of mountain activity. Event Incidence rate is expressed as the occurrence of new cases per 1000 hours of mountain activity.
  
  
  RESULTS
  Two hundred two patients were included during the study period. Trauma (65.1% vs. 24.6%, p < 0.001) and head commotive injury (48.1% vs. 15.1%, p < 0.001) were more frequent during winter compared to the summer season. High altitude illness (36.9% vs. 9.3%, p < 0.001) and cold pathologies (15.1% vs. 0.1%, p < 0.001) occurred more frequently in summer than in winter. Patients (51.4%) were immediately discharged from emergency room, 8.4% after a 24-hour observation period, and 30.6% required hospitalization. During summer, the event risk is 0.013 per person and 1000 hours of mountain activity, while in winter, event risk amounts to 0.005 per person and 1000 hours of mountain activity.
  
  
  CONCLUSIONS
  High altitude medical events or trauma represent <1% of pathologies observed in the emergency room department of a mountain district in the western Alps. Head commotive injury is the most observed mountain-related event in high altitude, in winter and during ski practice. High altitude illness and cold injuries are observed more frequently in summer, during trekking or climbing activities.
authors.affiliation: 1 Department of Mountain Medicine, Aosta Regional Hospital , Aosta, Italy .|2 Department of HPB Surgery and Liver Transplantation, Hôpital Pitié-Salpêtrière , Paris, France .
authors.forename: Raffaele
authors.initials: R
authors.lastname: Brustia
authors.affiliation: 3 Department of ICU and Anaesthesiology, Aosta Regional Hospital , Aosta, Italy .
authors.forename: Giulia
authors.initials: G
authors.lastname: Enrione
authors.affiliation: 1 Department of Mountain Medicine, Aosta Regional Hospital , Aosta, Italy .|4 Department of Cardiology, Aosta Regional Hospital, Aosta, Italy .
authors.forename: Bruna
authors.initials: B
authors.lastname: Catuzzo
authors.affiliation: 1 Department of Mountain Medicine, Aosta Regional Hospital , Aosta, Italy .|5 Department of Emergency, Aosta Regional Hospital , Aosta, Italy .
authors.forename: Luca
authors.initials: L
authors.lastname: Cavoretto
authors.affiliation: 5 Department of Emergency, Aosta Regional Hospital , Aosta, Italy .
authors.forename: Massimo
authors.initials: M
authors.lastname: Pesenti Campagnoni
authors.affiliation: 3 Department of ICU and Anaesthesiology, Aosta Regional Hospital , Aosta, Italy .
authors.forename: Enrico
authors.initials: E
authors.lastname: Visetti
authors.affiliation: 6 IFREMMONT, Hôpitaux du Mont Blanc , Chamonix, France .
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Cauchy
authors.affiliation: 3 Department of ICU and Anaesthesiology, Aosta Regional Hospital , Aosta, Italy .
authors.forename: Stefanie
authors.initials: S
authors.lastname: Ziegler
authors.affiliation: 1 Department of Mountain Medicine, Aosta Regional Hospital , Aosta, Italy .|7 Department of Neurology, Aosta Regional Hospital, Aosta, Italy .
authors.forename: Guido
authors.initials: G
authors.lastname: Giardini
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000531:Altitude; D000532:Altitude Sickness / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D004630:Emergencies / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007035:Hypothermia / Q000453:epidemiology* / Q000209:etiology; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009051:Mountaineering / Q000293:injuries / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012621:Seasons; D055815:Young Adult
keywords: HACE; HAPE; acute mountain sickness; alpine environment; alpine rescue; alpine sport; frostbite; high altitude illness; high altitude sport; hypothermia; hypoxia; mountain epidemiology; prospective observational study; trauma