Risk prediction score for severe high altitude illness: a cohort study.

<h4>Background</h4>Risk prediction of acute mountain sickness, high altitude (HA) pulmonary or cerebral edema is currently based on clinical assessment. Our objective was to develop a risk prediction score of Severe High Altitude Illness (SHAI) combining clinical and physiological factor...

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Autores principales:	Florence Canouï-Poitrine, Kalaivani Veerabudun, Philippe Larmignat, Murielle Letournel, Sylvie Bastuji-Garin, Jean-Paul Richalet
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/5a8bb6e6f3214bf88575a7ad303f464b
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spelling	oai:doaj.org-article:5a8bb6e6f3214bf88575a7ad303f464b2021-11-25T06:06:55ZRisk prediction score for severe high altitude illness: a cohort study.1932-620310.1371/journal.pone.0100642https://doaj.org/article/5a8bb6e6f3214bf88575a7ad303f464b2014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/25068815/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Risk prediction of acute mountain sickness, high altitude (HA) pulmonary or cerebral edema is currently based on clinical assessment. Our objective was to develop a risk prediction score of Severe High Altitude Illness (SHAI) combining clinical and physiological factors. Study population was 1017 sea-level subjects who performed a hypoxia exercise test before a stay at HA. The outcome was the occurrence of SHAI during HA exposure. Two scores were built, according to the presence (PRE, n = 537) or absence (ABS, n = 480) of previous experience at HA, using multivariate logistic regression. Calibration was evaluated by Hosmer-Lemeshow chisquare test and discrimination by Area Under ROC Curve (AUC) and Net Reclassification Index (NRI).<h4>Results</h4>The score was a linear combination of history of SHAI, ventilatory and cardiac response to hypoxia at exercise, speed of ascent, desaturation during hypoxic exercise, history of migraine, geographical location, female sex, age under 46 and regular physical activity. In the PRE/ABS groups, the score ranged from 0 to 12/10, a cut-off of 5/5.5 gave a sensitivity of 87%/87% and a specificity of 82%/73%. Adding physiological variables via the hypoxic exercise test improved the discrimination ability of the models: AUC increased by 7% to 0.91 (95%CI: 0.87-0.93) and 17% to 0.89 (95%CI: 0.85-0.91), NRI was 30% and 54% in the PRE and ABS groups respectively. A score computed with ten clinical, environmental and physiological factors accurately predicted the risk of SHAI in a large cohort of sea-level residents visiting HA regions.Florence Canouï-PoitrineKalaivani VeerabudunPhilippe LarmignatMurielle LetournelSylvie Bastuji-GarinJean-Paul RichaletPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 7, p e100642 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Florence Canouï-Poitrine Kalaivani Veerabudun Philippe Larmignat Murielle Letournel Sylvie Bastuji-Garin Jean-Paul Richalet Risk prediction score for severe high altitude illness: a cohort study.
description	<h4>Background</h4>Risk prediction of acute mountain sickness, high altitude (HA) pulmonary or cerebral edema is currently based on clinical assessment. Our objective was to develop a risk prediction score of Severe High Altitude Illness (SHAI) combining clinical and physiological factors. Study population was 1017 sea-level subjects who performed a hypoxia exercise test before a stay at HA. The outcome was the occurrence of SHAI during HA exposure. Two scores were built, according to the presence (PRE, n = 537) or absence (ABS, n = 480) of previous experience at HA, using multivariate logistic regression. Calibration was evaluated by Hosmer-Lemeshow chisquare test and discrimination by Area Under ROC Curve (AUC) and Net Reclassification Index (NRI).<h4>Results</h4>The score was a linear combination of history of SHAI, ventilatory and cardiac response to hypoxia at exercise, speed of ascent, desaturation during hypoxic exercise, history of migraine, geographical location, female sex, age under 46 and regular physical activity. In the PRE/ABS groups, the score ranged from 0 to 12/10, a cut-off of 5/5.5 gave a sensitivity of 87%/87% and a specificity of 82%/73%. Adding physiological variables via the hypoxic exercise test improved the discrimination ability of the models: AUC increased by 7% to 0.91 (95%CI: 0.87-0.93) and 17% to 0.89 (95%CI: 0.85-0.91), NRI was 30% and 54% in the PRE and ABS groups respectively. A score computed with ten clinical, environmental and physiological factors accurately predicted the risk of SHAI in a large cohort of sea-level residents visiting HA regions.
format	article
author	Florence Canouï-Poitrine Kalaivani Veerabudun Philippe Larmignat Murielle Letournel Sylvie Bastuji-Garin Jean-Paul Richalet
author_facet	Florence Canouï-Poitrine Kalaivani Veerabudun Philippe Larmignat Murielle Letournel Sylvie Bastuji-Garin Jean-Paul Richalet
author_sort	Florence Canouï-Poitrine
title	Risk prediction score for severe high altitude illness: a cohort study.
title_short	Risk prediction score for severe high altitude illness: a cohort study.
title_full	Risk prediction score for severe high altitude illness: a cohort study.
title_fullStr	Risk prediction score for severe high altitude illness: a cohort study.
title_full_unstemmed	Risk prediction score for severe high altitude illness: a cohort study.
title_sort	risk prediction score for severe high altitude illness: a cohort study.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/5a8bb6e6f3214bf88575a7ad303f464b
work_keys_str_mv	AT florencecanouipoitrine riskpredictionscoreforseverehighaltitudeillnessacohortstudy AT kalaivaniveerabudun riskpredictionscoreforseverehighaltitudeillnessacohortstudy AT philippelarmignat riskpredictionscoreforseverehighaltitudeillnessacohortstudy AT murielleletournel riskpredictionscoreforseverehighaltitudeillnessacohortstudy AT sylviebastujigarin riskpredictionscoreforseverehighaltitudeillnessacohortstudy AT jeanpaulrichalet riskpredictionscoreforseverehighaltitudeillnessacohortstudy
_version_	1718414164095926272

Risk prediction score for severe high altitude illness: a cohort study.

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