Zhu Yeyi, Hernandez Ladia M, Dong Yongquan, Himes John H, Caulfield Laura E, Kerver Jean M, Arab Lenore, Voss Paula, Hirschfeld Steven, Forman Michele R
Kaiser Permanente Northern California Division of Research, 2000Broadway, Oakland, CA94612, USA.
Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA.
Public Health Nutr. 2019 Jan;22(1):147-156. doi: 10.1017/S1368980018002549. Epub 2018 Oct 18.
In resource-constrained facilities or during resuscitation, immediate paediatric weight estimation remains a fundamental challenge. We aimed to develop and validate weight estimation models based on ulna length and forearm width and circumference measured by simple and portable tools; and to compare them against previous methods (advanced paediatric life support (APLS), Theron and Traub-Johnson formulas).
Cross-sectional analysis of anthropometric measurements. Four ulna- and forearm-based weight estimation models were developed in the training set (n 1016). Assessment of bias, precision and accuracy was examined in the validation set (n 457).
National Children's Study-Formative Research in Anthropometry (2011-2012).
Multi-racial/ethnic infants and children aged <6 years (n 1473).
Developed Models 1-4 had high predictive precision (R 2=0·91-0·97). Mean percentage errors between predicted and measured weight were significantly smaller across the developed models (0·1-0·7 %) v. the APLS, Theron and Traub-Johnson formulas (-1·7, 9·2 and -4·9 %, respectively). Root-mean-squared percentage error was overall smaller among Models 1-4 v. the three existing methods (range=7·5-8·7 v. 9·8-13·3 %). Further, Models 1-4 were within 10 and 20 % of actual weight in 72-87 and 95-99 % of the weight estimations, respectively, which outperformed any of the three existing methods.
Ulna length, forearm width and forearm circumference by simple and portable tools could serve as valid and reliable surrogate measures of weight among infants and children aged <6 years with improved precision over the existing age- or length-based methods. Further validation of these models in physically impaired or non-ambulatory children is warranted.
在资源有限的医疗机构或复苏过程中，即时估计小儿体重仍然是一项根本性挑战。我们旨在开发并验证基于尺骨长度以及使用简单便携工具测量的前臂宽度和周长的体重估计模型；并将其与先前的方法（高级儿科生命支持（APLS）、塞伦公式和特劳布 - 约翰逊公式）进行比较。
人体测量数据的横断面分析。在训练集（n = 1016）中开发了四个基于尺骨和前臂的体重估计模型。在验证集（n = 457）中检查偏差、精密度和准确性评估。
全国儿童研究 - 人体测量学形成性研究（2011 - 2012年）。
年龄小于6岁的多种族/族裔婴幼儿及儿童（n = 1473）。
开发的模型1 - 4具有较高的预测精度（R² = 0.91 - 0.97）。与APLS、塞伦公式和特劳布 - 约翰逊公式相比，开发的模型预测体重与实测体重之间的平均百分比误差显著更小（分别为0.1 - 0.7% 与 -1.7%、9.2% 和 -4.9%）。模型1 - 4的均方根百分比误差总体上小于三种现有方法（范围为7.5 - 8.7 与 9.8 - 13.3%）。此外，模型1 - 4分别在72 - 87% 和95 - 99% 的体重估计中，估计体重在实际体重的10% 和20% 以内，这优于三种现有方法中的任何一种。
使用简单便携工具测量的尺骨长度、前臂宽度和前臂周长可作为年龄小于6岁婴幼儿及儿童体重的有效且可靠的替代测量指标，其精度优于现有的基于年龄或长度的方法。有必要在身体有损伤或不能行走的儿童中进一步验证这些模型。
