Background characteristics of cases and controls.

High elevation adventures are popular among travelers; however, they carry significant health risks, such as altitude sickness. This study aims to identify risk factors associated with high altitude sickness among travelers to Mustang district. A health-facility-based, age-sex matched 1:1 case-control study was conducted in Mustang district hospital, Nepal. Measurements included Acute Mountain Sickness/High Altitude Cerebral Edema/High Altitude Pulmonary Edema assessment via LLS questionnaire, demographics, medical history, ascent rate, and prophylactic medicine intake. Data were collected between September and November, 2023 via predesigned structured questionnaire by trained medical officers in, and analyzed using SPSS version 25. Using binary logistic regression, the study tested potential risk factors associated with altitude sickness. Ethical approval was obtained from the NHRC, and written informed consent was obtained from all participants. A total of 63 cases (individuals with altitude sickness) and 63 controls (without) were interviewed. The mean age of cases and controls was 48.5 years (SD = 16.5) and 48 years (SD = 16.9) respectively. 38 were rapid ascenders, and 88 were slow ascenders. Awareness of altitude sickness was reported by 65 individuals, with 36 taking prophylactic medication (Acetazolamide 125/250mg). Among cases, 8 experienced HACE, 42 had AMS, and 13 had HAPE. Rapid ascent (Adjusted Odds Ratio [AOR]: 6.41, 95% Confidence Interval [CI]: 2.36-17.54), individuals with a previous history of illness (AOR: 10.20, 95% CI: 2.70-38.46), and failing to take prophylactic medication (AOR: 10.01, 95% CI: 1.896-10.680) were linked to an increased risk of altitude sickness. Our study highlights the critical role of ascent speed, previous history of illness, and use of prophylactic measures in development of altitude sickness.

高海拔探险活动深受旅行者青睐，但此类活动伴随显著健康风险，例如高原病（altitude sickness）。本研究旨在明确前往尼泊尔马斯唐区（Mustang District）的旅行者中，与高原病相关的危险因素。本研究采用基于医疗机构的1:1年龄-性别匹配病例对照研究设计，在尼泊尔马斯唐区医院开展。评估内容包括：通过LLS问卷（LLS questionnaire）完成的急性高原病（Acute Mountain Sickness, AMS）、高原脑水肿（High Altitude Cerebral Edema, HACE）、高原肺水肿（High Altitude Pulmonary Edema, HAPE）评估，以及人口统计学信息、既往病史、登山上升速率、预防性药物服用情况。研究数据于2023年9月至11月期间，由经过培训的医务人员通过预先设计的结构化问卷采集，并采用SPSS 25.0统计软件（SPSS version 25）进行分析。本研究采用二元逻辑回归（binary logistic regression）模型，检验与高原病相关的潜在危险因素。本研究已获得尼泊尔国家卫生研究委员会（NHRC）的伦理审批，所有参与者均签署了书面知情同意书。最终共纳入63例高原病病例组受试者与63例健康对照组受试者。病例组与对照组的平均年龄分别为48.5岁（标准差SD=16.5）与48岁（标准差SD=16.9）。其中38人为快速登山者，88人为慢速登山者。共有65名参与者知晓高原病相关知识，其中36人服用了预防性药物乙酰唑胺（Acetazolamide）125/250mg。病例组中，8人罹患高原脑水肿（HACE）、42人患有急性高原病（AMS）、13人出现高原肺水肿（HAPE）。统计分析结果显示，快速登山（调整后优势比[AOR]=6.41，95%置信区间[CI]=2.36~17.54）、既往患病史（AOR=10.20，95%CI=2.70~38.46）以及未服用预防性药物（AOR=10.01，95%CI=1.896~10.680）均与高原病发病风险升高显著相关。本研究强调了登山速率、既往患病史以及预防性防护措施的使用在高原病发病过程中的关键作用。