From the Department of Anaesthesia, University of Zambia and Zambia Airforce Medical Services, Air Headquarters Hospital, Lusaka, Zambia.
Department of Anaesthesia, University Hospital Bristol, Bristol, United Kingdom.
Anesth Analg. 2022 Jan 1;134(1):171-177. doi: 10.1213/ANE.0000000000005797.
In children, the use of actual weight or predicted weight from various estimation methods is essential to reduce harm associated with dosing errors. This study aimed to validate the new locally derived Lusaka formula on an independent cohort of children undergoing surgery at the University Teaching Hospital in Lusaka, Zambia, to compare the Lusaka formula's performance to commonly used weight prediction tools and to assess the nutritional status of this population.
The Lusaka formula (weight = [age in months/2] + 3.5 if under 1 year; weight = 2×[age in years] + 7 if older than 1 year) was derived from a previously published data set. We aimed to validate this formula in a new data set. Weights, heights, and ages of 330 children up to 14 years were measured before surgery. Accuracy was examined by comparing the (1) mean percentage error and (2) the percentage of actual weights that fell between 10% and 20% of the estimated weight for the Lusaka formula, and for other existing tools. World Health Organization (WHO) growth charts, mid upper arm circumference (MUAC), and body mass index (BMI) were used to assess nutritional status.
The Lusaka formula had similar precision to the Broselow tape: 160 (48.5%) vs 158 (51.6%) children were within 10% of the estimated weight, 241 (73.0%) vs 245 (79.5%) children were within 20% of the estimated weight. The Lusaka formula slightly underestimated weight (mean bias, -0.5 kg) in contrast to all other predictive tools, which overestimated on average. Twenty-two percent of children had moderate or severe chronic malnutrition (stunting) and 4.7% of children had moderate or severe acute malnutrition (wasting).
The Lusaka formula is comparable to, or better than, other age-based weight prediction tools in children presenting for surgery at the University Teaching Hospital in Lusaka, Zambia, and has the advantage that it covers a wider age range than tools with comparable accuracy. In this population, commonly used aged-based prediction tools significantly overestimate weights.
在儿童中，使用实际体重或各种估计方法预测的体重对于减少与剂量错误相关的危害至关重要。本研究旨在验证新的卢萨卡公式在赞比亚卢萨卡教学医院接受手术的另一组儿童中的有效性，比较卢萨卡公式的性能与常用的体重预测工具，并评估该人群的营养状况。
卢萨卡公式（体重=[月龄/2]+3.5（1 岁以下）；体重=2×[年龄/年]+7（1 岁以上））是从之前发表的数据集中得出的。我们旨在验证该公式在新数据集中的有效性。在手术前测量了 330 名 14 岁以下儿童的体重、身高和年龄。通过比较（1）平均百分比误差和（2）卢萨卡公式的实际体重落在估计体重的 10%和 20%之间的百分比，以及其他现有工具，来评估准确性。世界卫生组织（WHO）生长图表、上臂中部周长（MUAC）和体重指数（BMI）用于评估营养状况。
卢萨卡公式与 Broselow 带的精度相似：160（48.5%）名儿童的实际体重与估计体重相差 10%以内，241（73.0%）名儿童的实际体重与估计体重相差 20%以内。与所有其他预测工具相比，卢萨卡公式略微低估了体重（平均偏差为-0.5 公斤），而所有其他预测工具平均高估了体重。22%的儿童存在中度或重度慢性营养不良（发育迟缓），4.7%的儿童存在中度或重度急性营养不良（消瘦）。
在赞比亚卢萨卡教学医院接受手术的儿童中，卢萨卡公式与其他基于年龄的体重预测工具相当，或优于其他工具，并且具有优于其他工具的优势，即它的适用年龄范围比具有类似准确性的工具更广泛。在该人群中，常用的基于年龄的预测工具显著高估了体重。
