Decompression Sickness (DCS) is caused by a change in atmospheric pressure, as is experienced by scuba divers. This illness has gone from a small, predominately military existence into the larger civilian population as scuba diving continues to grow in popularity. The treatment for DCS is recompression in a hyperbaric chamber with oxygen (HBO). However, over a third of recreational divers treated for DCS report residual symptoms after treatment is complete. Although there have been numerous studies on the type of treatment in a hyperbaric chamber as well as the effects of delay to recompression on the treatment outcome, the effect of presenting symptoms of DCS on the outcome of HBO is not well understood. This study examined potential relationships between presenting symptoms of DCS and the final outcome post-complete HBO therapy Data were obtained from Divers Alert Network, which collects comprehensive data on U.S. recreational diving injuries. Among the 3,437 reported cases of DCS treated in HBO chambers from 1987--1995, 43.8% had residual symptoms after HBO. Approximately three-fourths of the cases were men. Due to possible confounding, analysis was stratified by gender Logistic and polytomous regression were used to predict residual symptoms after HBO. Controlling for age and delay from symptom onset to time of treatment, experiencing a bladder problem was highly associated with residuals post-HBO where persons with bladder problems were 5 times more likely to have residuals than those without the symptom Final models predicting residuals indicated that numbness/tingling [OR 1.74 (95% CI = 1.30, 2.33)] and muscle twitching [OR = 3.27 (95% CI = 1.51, 7.04)] were prognostic for women whereas difficulty walking/standing [OR 2.17 (95% CI = 1.565, 3.01)] and visual disturbance [OR = 2.47 (95% CI = 1.47, 4.15)] were prognostic for men. Predicted sensitivity of prognostic models ranged from 66 percent to 73 percent The results of this study found individual predictors to be of limited use in the clinical setting, as with these models, 30 percent of the time, cases with residuals were unexplained (unpredicted). This study did find that women and men appear to have different presenting symptoms of DCS and different predictive symptoms of residuals. This study should be generalizable to similar U.S. recreational divers / acase@tulane.edu
| Identifer | oai:union.ndltd.org:TULANE/oai:http://digitallibrary.tulane.edu/:tulane_27277 |
| Date | January 1999 |
| Contributors | Corson, Karen S (Author), Hassig, Susan E (Thesis advisor) |
| Publisher | Tulane University |
| Source Sets | Tulane University |
| Language | English |
| Detected Language | English |
| Rights | Access requires a license to the Dissertations and Theses (ProQuest) database., Copyright is in accordance with U.S. Copyright law |
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