Abstract
Rescue records of 98 mountaineering emergencies were reviewed to evaluate the risks of climbing North America's highest peak, Denali (6187 m). During a 10 year study period (1978–87) there were 126 search and rescue subjects, including 28 deaths (fatality rate = 4.3 per 1000 climbers; case fatality rate = 22.2%). Increased risk was significant at higher elevations ( p < 0.01), on technically difficult climbing routes ( p < 0.001), and for European and Asian climbers ( p < 0.001). Hazard is inherent to climbing; while prevention of mountaineering injuries is the ideal, development of skilled rescue and medical services is also essential.

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