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Risks factors for recurrent neurological decompression sickness in recreational divers: a case-control study.

E Gempp¹, P Louge, J E Blatteau

¹Department of Hyperbaric and Diving Medicine, Sainte Anne's Military Hospital, Toulon, France. gempp@voila.fr

The Journal of Sports Medicine and Physical Fitness

|September 15, 2012

Summary

Experienced divers, large right-to-left shunts (RLS), and unchanged diving practices increase the risk of recurrent decompression sickness (DCS). These factors are crucial for divers seeking to continue diving after an initial DCS episode.

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Area of Science:

Diving Medicine
Hyperbaric Physiology
Risk Factor Analysis

Background:

Recurrence of neurological decompression sickness (DCS) in scuba divers lacks identified predisposing factors.
Preventive measures for recurrent DCS are currently empirical.
Understanding risk factors is vital for divers continuing to dive post-DCS.

Purpose of the Study:

To identify individual and environmental factors predicting recurrent DCS in recreational divers.
To provide practical recommendations for divers resuming activity after a DCS event.

Main Methods:

A 12-year retrospective study of recreational divers treated for DCS.
Evaluation of age, gender, diving experience, and right-to-left shunt (RLS) presence.
Assessment of diving practices post-DCS resumption.

Main Results:

Experienced divers showed a higher risk of recurrent DCS (OR, 3.8).
Large RLS significantly increased the likelihood of a repeated DCS episode (OR, 5.4).
Failure to modify diving practices post-DCS was a strong predictor of recurrence (OR, 8.4).

Conclusions:

Divers should adopt conservative dive profiles or use oxygen-enriched air after initial DCS.
The utility of patent foramen ovale closure for preventing recurrent DCS warrants further investigation for divers unable to modify practices.