Correlation of patient observations and Lake Louise Score at Altitude
Date First Published:
July 22, 2019
Last Updated:
July 25, 2019
Report by:
Mark Willis, GPST1 (Bolton NHS Foundation Trust)
Search checked by:
Mark Willis, Bolton NHS Foundation Trust
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):
| Study Title | Patient Group | Study type (level of evidence) | Outcomes | Key results | Study Weaknesses |
|---|---|---|---|---|---|
| Pulse oximetry in the diagnosis of acute mountain sickness 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 | ||||
| Diagnosis and prediction of the occurrence of acute mountain sickness measuring oxygen saturation--independent of absolute altitude? Leichtfried, Veronika; Basic, Daniel; Burtscher, Martin; Gothe, Raffaella Matteucci; Siebert, Uwe; Schobersberger, Wolfgang Mar-16 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) | |
| Changes in oxygen saturation can not help diagnose acute mountain sickness (AMS): ascending to Lhasa on the Qinghai-Tibet train. Jun-Bo, A N; Hao-Ran, G U; Yu, W U; Yong-Jun, Luo Jun-16 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 | ||||
| Acute mountain sickness is related to nocturnal hypoxemia but not to hypoventilation. Erba, P; Anastasi, S; Senn, O; Maggiorirni, M; Bloch, K E Aug-04 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:
- O'Connor, Terry; Dubowitz, Gerald; Bickler, Phillip E. Pulse oximetry in the diagnosis of acute mountain sickness
- 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?
- 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.
- Erba, P; Anastasi, S; Senn, O; Maggiorirni, M; Bloch, K E . Acute mountain sickness is related to nocturnal hypoxemia but not to hypoventilation.
- Schultz, M G; Climie, R E D; Sharman, J E . Ambulatory and central haemodynamics during progressive ascent to high-altitude and associated hypoxia.
- ) 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.
- 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
- 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.
- Sutherland A; Freer J; Evans L; Dolci A; Crotti M; Macdonald JH . MEDEX 2015: Heart Rate Variability Predicts Development of Acute Mountain Sickness.
- 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.
- Wagner DR; Knott JR; Fry JP. Oximetry fails to predict acute mountain sickness or summit success during a rapid ascent to 5640 meters.