Publication Date:
2013-08-31
Description:
Circulating microbubbles (CMB) are frequently detected prior to the appearance of symptoms of Decompression Sickness (DCS). It is difficult to analyze the effect of CMB on symptoms due to differences in the time to detection of CMB. This paper uses survival analysis models to evaluate the risk of symptoms in the presence of CMB. Methods: Information on 81 exposures to an altitude of 6,400 m (6.5 psi) for a period of three hours, with simulated extravehicular activities, was examined. The presence or absence of CMB was included as a time dependent covariate of the Cox proportional hazards regression model. Using this technique, the subgroup of exposures with CMB was analyzed further. Mean (S.D.) time in minutes to onset of CMB and symptoms were 125 (63) and 165 (33) respectively, following the three hours exposure. The risk of symptoms (17/81) increased 14 times in the presence of CMB, after controlling for variations in time to detection of CMB. Further, the risk was lower when time to detection of CMB was greater than 60 minutes (risk ratio = 0.96; 95 percent confidence intervals = 0.94 - 0.99 0.99 P less than 0.01) compared to CMB before 60 minutes at altitude. Conclusions: Survival analysis showed that individual risk of DCS changes significantly due to variations in time to detection of CMB. This information is important in evaluating the risk of DCS in the presence of CMB.
Keywords:
AEROSPACE MEDICINE
Type:
Aerospace Medical Association, Aerospace Medical Association 63rd Annual Scientific Meeting Program; 1 p
Format:
application/pdf
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