Tanner Dennis, Negaard Ashley, Huang Rong, Evans Neil, Hennes Halim
From the *Cook Children's Hospital, Forth Worth; †Department of Pediatrics, Division of Pediatric Emergency Medicine, UT Southwestern; and ‡Children Medical Center, Dallas, TX.
Pediatr Emerg Care. 2017 Oct;33(10):675-678. doi: 10.1097/PEC.0000000000000894.
The aims of the study were to examine the predictive accuracy of Broselow tape (BT) weight estimation and body mass index-based weight categorization in overweight and obese pediatric patients and to develop an adjustment factor that improves the BT weight estimate in overweight and obese pediatric patients.
A prospective observational study was conducted. We enrolled noncritical pediatric patients presenting to a tertiary care pediatric emergency department with nonurgent complaints. Patients had their weights, heights, abdominal circumferences, and actual BT measurements documented by research staff.
One hundred seventy-eight patients aged 2 to 18 years were enrolled. Using the Centers for Disease Control and Prevention's definition of body mass index classification, 71 patients (39.89%) had normal BMI, 43 patients (24.16%) were overweight, and 64 patients (35.96%) were obese. The accuracy of the BT-estimated weight range, compared with the actual weight, is 40.5% in our study population. When stratified by BMI classification, the accuracy proportions were the following: 71.8% for normal, 41.9% for overweight, and 4.7% for obese patients. The adjustment formula ([0.014 × waistline in cm + 0.3] × BT weight) improved overall weight estimation from 40.5% to 65.2%. The greatest improvement was noted in obese children, where the BT accuracy improved from 4.7% to 59.4%.
The growing pediatric obesity epidemic has challenged the BT's ability to accurately estimate the weights in overweight and obese pediatric patients. Our study demonstrated inverse relationship between the accuracy of BT and body weight. An adjustment factor significantly improved BT accuracy in obese children.
本研究旨在检验布罗泽洛卷尺（BT）体重估计法以及基于体重指数的体重分类法对超重和肥胖儿科患者体重预测的准确性，并制定一个调整因子，以提高BT对超重和肥胖儿科患者体重估计的准确性。
开展了一项前瞻性观察研究。我们纳入了到三级护理儿科急诊科就诊、主诉非紧急情况的非危重症儿科患者。研究人员记录了患者的体重、身高、腹围以及实际的BT测量值。
纳入了178例年龄在2至18岁之间的患者。根据疾病控制与预防中心的体重指数分类定义，71例患者（39.89%）体重指数正常，43例患者（24.16%）超重，64例患者（35.96%）肥胖。在我们的研究人群中，与实际体重相比，BT估计体重范围的准确性为40.5%。按体重指数分类分层时，准确性比例如下：正常体重者为71.8%，超重者为41.9%，肥胖患者为4.7%。调整公式（[0.014×腰围（厘米）+0.3]×BT体重）将总体重估计的准确性从40.5%提高到了65.2%。肥胖儿童的改善最为显著，BT的准确性从4.7%提高到了59.4%。
儿科肥胖症的日益流行对BT准确估计超重和肥胖儿科患者体重的能力提出了挑战。我们的研究表明BT的准确性与体重之间存在反比关系。一个调整因子显著提高了肥胖儿童中BT的准确性。
