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Three Part Question

In [adults patients travelling to an altitude greater than 3500m] does [the patient's variation of vital observations at rest] correlate with [the patient's Lake Louise Score]?

Relevant Paper(s)

Author, date and country	Patient group	Study type (level of evidence)	Outcomes	Key results	Study Weaknesses
O'Connor, Terry; Dubowitz, Gerald; Bickler, Phillip E 2004 United States	169 adult subjects who had recently arrived by foot at 3080 m	Subjects completed a demographic survey, which collected data on ascent profiles and AMS symptoms. Resting arterial oxygen saturation and pulse rate were then measured using finger pulse oximetry. Forty-six subjects (27%) had AMS, using the Lake Louise score.	Heart Rate	significantly associated with the presence of AMS (OR: 1.4; 95% CI, 1.1 to 1.9; p < 0.05, backwards stepwise logistical regression)
			Pulse Oximetry	No association between pulse oximetry and Acute Mountain Sickness
Leichtfried, Veronika; Basic, Daniel; Burtscher, Martin; Gothe, Raffaella Matteucci; Siebert, Uwe; S Mar 2016 Germany	204 adult participants travelling on foot to altitude.	Pulse Oximetry was measured and the Lake Louise Self-assessment Score (LLS) was administered over the first 7 days of their trek (2500m to 5500m).	Pulse Oximetry	There is no strong association between AMS and pulse oximetry during the first week of high-altitude adaptation (ρ ranging from -0.142 to -0.370)
Jun-Bo, A N; Hao-Ran, G U; Yu, W U; Yong-Jun, Luo Jun 2016 China	58 young male adults who traveled from Chongqing (300 m) to Lhasa (3658 m) by train	Data was collected on the ascent profiles and AMS symptoms based on the Lake Louise Score (LLS). The resting arterial oxygen saturation (R-SpO2) and pulse rate were then measured using finger pulse oximetry. There was no significant correlation between pulse oximetry/heart rate and AMS LLS.	Resting Pulse Oximetry	Pulse Oximetry was significantly lower in the AMS (Lake Louise >3) group than in the group without AMS (Lake Louise Score <3) (P<0.05) at 2800m and 5200m
			Resting Pulse Oximetry	Pulse Oximetry was higher in the AMS group than in the non-AMS group (P<0.05) at 3658m.
			Resting Heart Rate	Heart Rate in the AMS group were higher than those in the non-AMS group (p<0.05) at 2200m and 2800m
			Resting Heart Rate	Heart Rate in the AMS group was lower than those in the non-AMS group (p<0.05) at 3658m and 5200m
Erba, P; Anastasi, S; Senn, O; Maggiorirni, M; Bloch, K E Aug 2004 England	A total of 21 adult climbers were studied ascending from <1,200 m to Capanna Regina Margherita, a hut in the Alps at 4,559 m	A total of 21 adult climbers were studied ascending from <1,200 m to Capanna Regina Margherita, a hut in the Alps at 4,559 m, within or =5) and 10 did not (controls)	Noctural Resting Pulse Oximetry	subjects with acute mountain sickness had lower nocturnal oxygen saturation (mean+/-SD 59+/-13% versus 73+/-6%)

References

1. O'Connor, Terry; Dubowitz, Gerald; Bickler, Phillip E Pulse oximetry in the diagnosis of acute mountain sickness High altitude medicine & biology 2004; vol. 5 (no. 3); p. 341-348
2. Leichtfried, Veronika; Basic, Daniel; Burtscher, Martin; Gothe, Raffaella Matteucci; Siebert, Uwe; Schobersberger, Wolfgang Diagnosis and prediction of the occurrence of acute mountain sickness measuring oxygen saturation--independent of absolute altitude? Sleep & breathing Mar 2016; vol. 20 (no. 1); p. 435-442
3. Jun-Bo, A N; Hao-Ran, G U; Yu, W U; Yong-Jun, Luo Changes in oxygen saturation can not help diagnose acute mountain sickness (AMS): ascending to Lhasa on the Qinghai-Tibet train. Chinese journal of applied physiology Jun 2016; vol. 32 (no. 6); p. 519-524
4. Erba, P; Anastasi, S; Senn, O; Maggiorirni, M; Bloch, K E Acute mountain sickness is related to nocturnal hypoxemia but not to hypoventilation. The European respiratory journal Aug 2004; vol. 24 (no. 2); p. 303-308
5. Schultz, M G; Climie, R E D; Sharman, J E Ambulatory and central haemodynamics during progressive ascent to high-altitude and associated hypoxia. Journal of human hypertension Dec 2014; vol. 28 (no. 12); p. 705-710
6. ) Mandolesi, Gaia; Avancini, Giovanni; Bartesaghi, Manuela; Bernardi, Eva; Pomidori, Luca; Cogo, Annalisa Long-term monitoring of oxygen saturation at altitude can be useful in predicting the subsequent development of moderate-to-severe acute mountain sickness. Wilderness & environmental medicine Dec 2014; vol. 25 (no. 4); p. 384-391
7. Chen, Hang-Cheng; Lin, Wen-Ling; Wu, Jiunn-Yih; Wang, Shih-Hao; Chiu, Te-Fa; Weng, Yi-Ming; Hsu, Tai-Yi; Wu, Meng-Huan Change in oxygen saturation does not predict acute mountain sickness on Jade Mountain Wilderness & environmental medicine Jun 2012; vol. 23 (no. 2); p. 122-127
8. Gonggalanzi; Labasangzhu; Bjertness E; Wu T; Stigum H; Nafstad P Acute mountain sickness, arterial oxygen saturation and heart rate among Tibetan students who reascend to Lhasa after 7 years at low altitude: a prospective cohort study. BMJ open Jul 2017; vol. 7 (no. 7); p. e016460
9. Sutherland A; Freer J; Evans L; Dolci A; Crotti M; Macdonald JH MEDEX 2015: Heart Rate Variability Predicts Development of Acute Mountain Sickness. High altitude medicine & biology Sep 2017; vol. 18 (no. 3); p. 199-208
10. Zhao SY; Wu XM; Guo YM; Zhang SS; An YM; Li B; Wang H Study of blood oxygen saturation, heart rate changes and plateau reaction of the Antarctic Kunlun station investigation team in different plateau environments. Zhonghua yi xue za zhi Jun 2013; vol. 93 (no. 22); p. 1743-1745
11. Wagner DR; Knott JR; Fry JP Oximetry fails to predict acute mountain sickness or summit success during a rapid ascent to 5640 meters. Wilderness & environmental medicine Jun 2012; vol. 23 (no. 2); p. 114-121