Mortality on Mount Everest, 1921-2006: descriptive studyBMJ 2008; 337 doi: https://doi.org/10.1136/bmj.a2654 (Published 11 December 2008) Cite this as: BMJ 2008;337:a2654
- Paul G Firth, anaesthetist1,
- Hui Zheng, statistician2,
- Jeremy S Windsor, specialist registrar in anaesthetics and intensive care3,
- Andrew I Sutherland, Wellcome research training fellow4,
- Christopher H Imray, vascular surgeon5,
- G W K Moore, professor6,
- John L Semple, professor7,
- Robert C Roach, associate professor8,
- Richard A Salisbury, computer analyst9
- 1Department of Anesthesia and Critical Care, Massachusetts General Hospital, Boston, MA 02114, USA
- 2Biostatistics Center, Massachusetts General Hospital, Boston
- 3Heart Hospital, London
- 4Nuffield Department of Surgery, John Radcliffe Hospital, Oxford
- 5Department of Surgery, University Hospital, Coventry
- 6Department of Physics, University of Toronto, Canada
- 7Department of Surgery, University of Toronto
- 8University of Colorado Denver Health Sciences Center, Aurora, Colorado, USA
- 9Ann Arbor, Michigan, USA
- Correspondence to: P Firth
- Accepted 9 November 2008
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.
We thank Gary Landeck and Mike Weichert (American Alpine Club Library, USA) and Yvonne Sibbald (Alpine Club Library, UK) for their help in locating articles; the many Everest mountaineers from around the world who patiently provided details of deaths; Charlie Cote and Scott Tolle (Massachusetts General Hospital) for assistance in the preparation of the manuscript; and Armin Gruen and Martin Sauerbier (Institute of Geodesy and Photogrammetry, Switzerland) for data and assistance in constructing the route profile.
Contributors: PGF, JSW, AIS, CHI, JLS, and RCR constructed the classification system. PGF collected the accounts and interviewed climbers. PGF, JSW, AIS, and CHI analysed the reports. GWKM and JLS analysed the weather patterns. RAS provided data from the Himalayan Database. HZ did the statistical analysis. PGF wrote the manuscript with input from all authors. PGF is the guarantor of data related to the circumstances of death. GWKM is the guarantor of meteorological data. RAS is the guarantor of data from the Himalayan Database.
Competing interest: RAS has a financial interest in the Himalayan Database.
Ethical approval: This study was approved by the institutional review board of Massachusetts General Hospital.
Provenance and peer review: Not commissioned; externally peer reviewed.
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