CHRISTMAS 2008: SPORT Mortality on Mount Everest, 1921-2006: descriptive study
CHRISTMAS 2008: SPORT Mortality on Mount Everest, 1921-2006: descriptive study
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DOI：
10.1136/bmj.a2654
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发表时间：
2008-12-11
影响因子：
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通讯作者：
Salisbury, Richard A.
中科院分区：
文献类型：
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作者：
Firth, Paul G.;Zheng, Hui;Salisbury, Richard A.
目的研究86年来珠峰登山者的死亡模式。设计描述性研究。设置1921- 2006年攀登珠峰的登山探险队。参与者14138名登山者; 8030名登山者和6108名夏尔巴人。主要结果测量死亡情况。结果大本营以上登山者的死亡率为1.3%。死亡可分类为涉及创伤（客观危险或福尔斯，n= 113）、非创伤性（高原病、体温过低或猝死，n= 52）或失踪（尸体未找到，n= 27）。在1982年至2006年的春季登山季节，82.3%的登山者死亡发生在试图登顶的过程中。登山者通过标准路线下山的死亡率高于夏尔巴人（2.7%（43/ 1585）vs0.4%（5/ 1231），P< 0.001;所有登山者为1.9%）。在攀登8000米以上的94名登山运动员中，53名（56%）在从山顶下降时死亡，16名（17%）在返回后死亡，9名（10%）在上升过程中死亡，4名（5%）在离开最后营地之前死亡，12名（13%）的登山运动员在登顶阶段未知。幸存者通过标准路线到达顶峰的中位时间早于非幸存者（0900- 0959 v1300 - 1359，P< 0.001）。严重疲劳（n= 34）、认知变化（n= 21）和共济失调（n= 12）是死亡者报告的最常见症状，而呼吸窘迫（n= 5）、头痛（n= 0）、恶心或呕吐（n= 3）结论在从珠穆朗玛峰峰顶下降的过程中，通常会出现与高海拔脑水肿一致的衰弱症状珠峰。深度疲劳和到达顶峰的时间较晚是与随后死亡相关的早期特征。
Objective To examine patterns of mortality among climbers on Mount Everest over an 86 year period.Design Descriptive study.Setting Climbing expeditions to Mount Everest, 1921-2006.Participants 14 138 mountaineers; 8030 climbers and 6108 sherpas.Main outcome measure 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.