Division of Emergency Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and Department of Emergency Medicine, University College Hospital, Ibadan, Nigeria.
S Afr Med J. 2021 Feb 1;111(2):166-170. doi: 10.7196/SAMJ.2021.v111i2.15061.
The weight of a patient is an important variable that impacts on their medical care. Although some drugs are prescribed on a so-called 'adult dose' basis, we know that adults come in all shapes and sizes - a 'one-dose-fits-all' approach is not necessarily appropriate. As a measured weight may not always be available, an alternative method of accurately estimating weight is required.
To assess and compare the accuracy of weight estimations in adults by patient self-estimation, the Mercy method, Buckley method, Broca index and PAWPER XL-MAC (paediatric advanced weight prediction in the emergency room eXtra length/eXtra large mid-arm circumference) method.
This was a prospective, cross-sectional study conducted at a tertiary academic hospital in a metropolitan area of Johannesburg, South Africa. Anthropometric variables of height, abdominal circumference, thigh circumference, mid-arm circumference and humeral length were measured. These variables were then applied to the various weight estimation methods and compared with the patient's actual weight.
There were 188 adult patients included in the study. None of the methodologies evaluated in this study achieved the recommended >70% of weight estimations within 10% of the patient's actual weight (PW10). The Mercy method was the closest to achieving greater than the recommended 95% for weight estimation falling within 20% of the patient's actual weight (PW20). The PW20 for the Mercy method was 91.5%. The PAWPER XL-MAC and patient self-estimate methods achieved a PW20 of 85.1% and 86.1%, respectively. The Broca and Buckley methods performed poorly overall.
None of the evaluated weight estimation methodologies was accurate enough for use in adult weight estimation. The Mercy and PAWPER XL-MAC methodologies both showed significant promise for use in adult weight estimation, but need further refinement. Although patient self-estimates were similarly accurate to those found in previous studies, they were not an accurate option; self-estimations would remain the first choice if the patient was able to provide such an estimation. The Broca index and Buckley method cannot be recommended owing to their poor performance.
患者的体重是影响其医疗的重要变量。尽管某些药物按所谓的“成人剂量”开处方，但我们知道成人有各种体型和大小——“一刀切”的方法不一定合适。由于可能无法始终获得测量体重，因此需要一种准确估计体重的替代方法。
评估和比较患者自我估计、Mercy 方法、Buckley 方法、Broca 指数和 PAWPER XL-MAC（急诊室儿科先进体重预测额外长度/额外大臂围）方法在成人中的体重估计准确性。
这是一项在南非约翰内斯堡大都市区的一家三级学术医院进行的前瞻性、横断面研究。测量了身高、腹围、大腿围、臂围和肱骨长度等人体测量学变量。然后将这些变量应用于各种体重估计方法，并与患者的实际体重进行比较。
本研究共纳入 188 名成年患者。在这项研究中评估的方法都没有达到建议的＞70%的体重估计值，误差在 10%以内（PW10）。Mercy 方法最接近达到＞95%的体重估计值，误差在 20%以内（PW20）。Mercy 方法的 PW20 为 91.5%。PAWPER XL-MAC 和患者自我估计方法的 PW20 分别为 85.1%和 86.1%。Broca 和 Buckley 方法总体表现不佳。
在评估的体重估计方法中，没有一种方法足够准确，无法用于成人体重估计。 Mercy 和 PAWPER XL-MAC 两种方法都显示出在成人体重估计中有很大的应用潜力，但需要进一步改进。尽管患者自我估计与之前研究中的结果同样准确，但自我估计并不是一个准确的选择；如果患者能够提供这样的估计，自我估计仍将是首选。Broca 指数和 Buckley 方法由于表现不佳，不能被推荐。
