Université Aix Marseille II / Faculté de Pharmacie la Timone, Marseille, France.
QJM. 2012 Aug;105(8):769-74. doi: 10.1093/qjmed/hcs060. Epub 2012 Apr 4.
To examine the bias and precision of different methods of estimating body mass and height in hospitalized adult patients.
Patients were enrolled at the Alfred and Caulfield hospitals, Melbourne, Australia following verbal consent. Estimates were made using the Lorenz formula (that utilizes height, waist and hip circumference), the Crandell formula (that utilizes height and arm circumference) and visual estimation of weight based on the average results obtained by two pharmacy interns. Statistical error was calculated as the ratio of estimated to actual weight; bias was assessed as the mean error and precision as the proportion of estimates within 10 and 20% of measured weight and standard deviation of the error.
In a 5-week period July to August 2010, 198 patients were enrolled. The median age was 64 years (range 19-91) and 52% were female. Thirty-four (17%) patients were obese (BMI >30 kg/m(2)) and 8 (4%) were underweight (BMI <18 kg/m(2)). With the Lorenz formula an estimate within 10% was obtained for 56% of patients; with the Crandell formula prediction was poor. Documentation of body weight in notes and patient self-reporting were both accurate. Seventy-two patients (43%) were prescribed one or more drugs for which dosing potentially should be adjusted for body weight.
In adult hospitalized patients, the estimation of body weight by anthropomorphic measures is not accurate. This supports the need for equipment to be made widely available to accurately weigh patients directly in hospital, including in unconscious and immobile patients.
检验不同方法估计住院成年患者体重和身高的偏倚和精密度。
患者在澳大利亚墨尔本的阿尔弗雷德医院和考菲尔德医院经口头同意后入选。使用洛伦兹公式(利用身高、腰围和臀围)、克兰德尔公式(利用身高和臂围)以及两名药剂实习学生的平均结果进行视觉体重估计来进行估计。统计误差计算为估计体重与实际体重的比值;偏倚评估为平均误差,精密度评估为估计值在实测体重的 10%和 20%之间的比例以及误差的标准差。
在 2010 年 7 月至 8 月的 5 周期间,共纳入 198 名患者。中位年龄为 64 岁(范围 19-91 岁),52%为女性。34 名(17%)患者肥胖(BMI>30kg/m(2)),8 名(4%)消瘦(BMI<18kg/m(2))。使用洛伦兹公式,56%的患者估计值在 10%以内;克兰德尔公式预测效果不佳。记录在病历中的体重和患者自我报告的体重均准确。72 名(43%)患者开有一种或多种药物,这些药物的剂量可能需要根据体重进行调整。
在住院成年患者中,通过人体测量法估计体重并不准确。这支持需要广泛提供设备以直接在医院准确称量患者体重,包括对无意识和不能活动的患者。