Inpatient treatment of trekkers and Nepalese workers in the high-altitude environment of Mt. Everest Region 1996-2011: A retrospective analysis

Abstract

Background: The study investigates the diagnoses of inpatients (tourists and Nepali workers) of Kunde Hospital (Mt.Everest region) over 15 years.

Methods: Records from January 1996 to September 2011 were analyzed concerning date, gender, age group, nationality, purpose of visit, diagnosis, length of treatment, and condition at discharge. Diagnoses were coded according to ICD-10-WHO 2010. Data were analyzed using descriptive statistics and non-parametric tests. P < 0.05 was defined as significant.

Results: 479 inpatients were included: 363 (75.8%) males (202 trekkers (42.2%), 277 Nepalese workers (57.8%)). Most suffered from altitude sickness (45.5%), acute gastroenteritis (10.4%) or acute respiratory infection (8.4%). Severe cases of altitude sickness amongst trekkers decreased but increased amongst workers. Severe cases of acute gastroenteritis amongst trekkers increased. Mean length of inpatient treatment was 4.6 days ±2.7 days. 573/2030 days of treatment were caused by altitude sickness. 70 patients were evacuated, 9 died.

Conclusion: Altitude illness caused the majority of inpatient treatment and acute gastroenteritis may be an underestimated risk for both groups. Other severe problems were mostly illnesses, not trauma. Improved prevention strategies are needed for both groups. For tourists who often show pre-existing diseases this includes an individual pre-travel expert advice. Nepali workers should be instructed concerning acclimatization.

Keywords: AMS; Acute gastroenteritis; HACE; HAPE; High-altitude; Mount Everest; Mountaineering; Nepal; Porter; Solu Khumbu; Trekking; traveler's diarrhea.