布罗塞洛、PAWPER XL、PAWPER XL-MAC 和 Mercy 胶带在儿童体重估计中的准确性。
Accuracy of Weight Estimation in Children Using the Broselow, PAWPER XL, PAWPER XL-MAC, and Mercy Tapes.
出版信息
Pediatr Emerg Care. 2022 Sep 1;38(9):e1517-e1522. doi: 10.1097/PEC.0000000000002638. Epub 2022 Feb 8.
OBJECTIVES
Quick and accurate estimate of a child's weight is often required for medical interventions like drug dose calculation when scale measured weights cannot be obtained safely. Length-based methods of weight estimation are more accurate than age-based methods, with the most accurate being the length-based, habitus-modified methods. This study sought to determine and compare the accuracies of the 2017 Broselow tape, Paediatric Advanced Weight Prediction in the Emergency Room Extra-Long (PAWPER XL) tape, Paediatric Advanced Weight Prediction in the Emergency Room Extra-Long Mid-Arm Circumference (PAWPER XL-MAC) tape, and the 2-dimensional (2D) Mercy tape in Ghanaian children.
METHODS
A cross-sectional study was conducted at the Tamale Teaching Hospital in Ghana. Eight hundred forty children between 2 months and 13 years had their weights estimated by the 2017 Broselow, PAWPER XL, PAWPER XL-MAC, and 2D Mercy tapes. Accuracy of the methods was determined by percentage of weight estimated to within 10% and 20% of actual weight. Mean percentage error and the Bland-Altman analysis were used to assess bias and precision.
RESULTS
The proportion of weight estimates within 10% and 20% of actual weight for Broselow tape were 47.5% and 82.3%, for 2D Mercy tape were 73.1% and 96.3%, for PAWPER XL-MAC were 77.6% and 97.5%, and for PAWPER XL were 81.7% and 96.8%, respectively. The Broselow tape had the greatest bias and least precision among the 4 methods. The Mercy, PAWPER XL-MAC, and PAWPER XL tapes had similar performance, but all performed significantly better than the Broselow tape in pairwise comparison. The best weight estimation method overall was the PAWPER XL tape as it also had the least bias and greatest precision.
CONCLUSIONS
The Mercy, PAWPER XL-MAC, and PAWPER XL tapes were more accurate than the 2017 Broselow tape and should be used in preference in Ghana and countries with similar population structure.
目的
在进行药物剂量计算等医疗干预时，经常需要快速准确地估计儿童的体重，而当无法安全地测量体重时，就需要用到这种方法。基于长度的体重估计方法比基于年龄的方法更准确，其中最准确的是基于长度且修正体型的方法。本研究旨在确定并比较 2017 年 Broselow 胶带、儿科先进体重预测在急诊室超长 (PAWPER XL) 胶带、儿科先进体重预测在急诊室超长中臂围 (PAWPER XL-MAC) 胶带和 Mercy 二维胶带在加纳儿童中的准确性。
方法
这是一项在加纳塔马利教学医院进行的横断面研究。840 名 2 个月至 13 岁的儿童使用 2017 年 Broselow、PAWPER XL、PAWPER XL-MAC 和 Mercy 二维胶带估计体重。通过估计体重与实际体重相差 10%和 20%的百分比来确定方法的准确性。平均百分比误差和 Bland-Altman 分析用于评估偏差和精度。
结果
Broselow 胶带估计体重在实际体重的 10%和 20%范围内的比例分别为 47.5%和 82.3%， Mercy 二维胶带分别为 73.1%和 96.3%，PAWPER XL-MAC 分别为 77.6%和 97.5%，PAWPER XL 分别为 81.7%和 96.8%。在这 4 种方法中，Broselow 胶带的偏差最大，精度最低。 Mercy、PAWPER XL-MAC 和 PAWPER XL 胶带的性能相似，但在两两比较中，所有方法的表现均明显优于 Broselow 胶带。总体而言，最佳的体重估计方法是 PAWPER XL 胶带，因为它的偏差最小，精度最高。
结论
Mercy、PAWPER XL-MAC 和 PAWPER XL 胶带比 2017 年 Broselow 胶带更准确，在加纳和人口结构相似的国家应优先使用。
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