Yakubu Rafiuk Cosmos, Nguah Samuel Blay, Ayi-Bisah Nedda
Department of Child Health, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
Tamale Teaching Hospital, Tamale, Ghana.
Afr J Emerg Med. 2021 Jun;11(2):252-257. doi: 10.1016/j.afjem.2021.03.005. Epub 2021 Apr 5.
Weight estimation in children is critical in paediatric emergencies. The Broselow Tape (BT) and most age-based formulae for weight estimation were derived in high-income countries and are thought to overestimate the weight of children in low-income countries. This study sought to validate the 2017 BT, and eight age-based weight estimation formulae among Ghanaian children and to derive a weight estimation formula using this data.
A cross-sectional study was conducted in the Tamale Teaching Hospital (TTH) in Ghana. Children aged between 2 months and 13 years had their weights estimated by the 2017 BT and eight age-based formulae. These estimated weights were compared to the weight of the children measured by a calibrated Seca scale using mean percentage error (MPE) and the percentage of weight estimates within 10% and 20% of actual weight. Bland-Altman method was used to assess agreement between estimated and actual weight of the children. A new formula was derived by linear regression.
Seven hundred and seventy-five children took part in the study. The 2017 BT, Original APLS (APLS1) and Nelson's formulae performed best with proportion of weight estimates within 10% of actual weight being 47.5%, 51.1% and 47.5% respectively. The formula developed in this study was: W = 3Am / 10 + 5 (for infants <12 months), W = 2A + 7 (1 to 4 years) and W = 2A + 9 (5 to 13 years), where W is estimated weight, A is age in completed months and A is age in completed years. The new formula had similar accuracy as the three best performing methods in this study.
The Broselow Tape, APLS1 and the Nelson's formula were the most accurate in this study. APLS1 and the Broselow Tape can be used for weight estimation in Ghanaian children when no other better method is available.
儿童体重估计在儿科急诊中至关重要。布罗泽洛卷尺(BT)和大多数基于年龄的体重估计公式是在高收入国家得出的,被认为高估了低收入国家儿童的体重。本研究旨在验证2017年版布罗泽洛卷尺以及八个基于年龄的体重估计公式在加纳儿童中的准确性,并利用这些数据得出一个体重估计公式。
在加纳的塔马利教学医院(TTH)进行了一项横断面研究。对年龄在2个月至13岁之间的儿童,使用2017年版布罗泽洛卷尺和八个基于年龄的公式对其体重进行估计。将这些估计体重与使用校准后的赛卡秤测量的儿童体重进行比较,采用平均百分比误差(MPE)以及体重估计值在实际体重的10%和20%范围内的百分比。采用布兰德-奥特曼方法评估估计体重与儿童实际体重之间的一致性。通过线性回归得出一个新公式。
775名儿童参与了该研究。2017年版布罗泽洛卷尺、原始高级儿科生命支持(APLS1)公式和纳尔逊公式表现最佳,体重估计值在实际体重10%范围内的比例分别为47.5%、51.1%和47.5%。本研究得出的公式为:对于12个月以下婴儿,W = 3Am / 10 + 5;对于1至4岁儿童,W = 2A + 7;对于5至13岁儿童,W = 2A + 9,其中W为估计体重,A为月龄整数值,A为年龄整数值。新公式的准确性与本研究中表现最佳的三种方法相似。
在本研究中,布罗泽洛卷尺、APLS1和纳尔逊公式最为准确。当没有其他更好的方法时,APLS1和布罗泽洛卷尺可用于加纳儿童的体重估计。