Climbing Smarter: A Predictive Model for Acute Mountain Sickness Risk at High Altitudes

Acute Mountain Sickness (AMS) is a common and potentially severe condition-affecting individual who ascend to high altitudes. Understanding the predictive factors associated with AMS is essential for prevent health risks in high-altitude environments. Objective : identify key demographic and physiological predictors of AMS and develop a logistic regression model to estimate the likelihood of its occurrence. Methods : A prospective, descriptive field study was conducted at the José Ribas refuge (4,800 m) on Cotopaxi volcano (5,898 m) in the Ecuadorian Andes. Volunteer mountaineers who spent at least eight hours at the refuge before attempting the summit were included. Demo-graphic and physiological variables were collected upon arrival and after 12 hours, at which point AMS was assessed using the Lake Louise AMS Self-Report questionnaire. Logistic regression models were employed with model calibration and discrimination assessed using the Brier score and AUROC, respectively. Internal validation was performed via bootstrap resampling and 10-fold cross-validation. Results : 136 volunteer mountaineers were included. Key predictive factors for AMS included (p < 0.05 for all) low arterial oxygen saturation (OR: 0.92 [95%CI: 0.85-0.99]), low diastolic blood pressure (OR: 0.96 [0.92-0.99]), prior history of AMS (OR: 2.80 [95%CI:1.17 -6.70]), and limited previous high-altitude experience (low OR: 18.25 [95%CI: 4.859 68.56], moderate OR: 5.14 [ 95%CI: 1.78-14.85]).The model demonstrated strong discriminatory performance, (AUROC of 0.83; 95% CI: 0.76-0.90), and a good calibration with a slope of 0.97 (95% CI: 0.77 to 1.17) and a Brier Score of 0.16. Internal validation confirmed model stability and robustness. Conclusion : The developed model effectively predicts AMS risk using readily measurable physiological and demographic variables. Its application could enhance risk assessment and preventive strategies for individuals engaging in high-altitude activities.