Acute Medicine, Harrogate District Hospital, Harrogate, UK.
Pain Service, Department of Anaesthesia, Alder Hey Children's NHS Foundation Trust, Liverpool, UK.
Arch Dis Child. 2023 Jul;108(7):578-582. doi: 10.1136/archdischild-2022-325267. Epub 2023 Apr 25.
To evaluate age-banded dosing in paediatric inpatients by determining the proportion of patients whose dose would fall outside the therapeutic range (by weight).
A retrospective observational study. Weight and height measurements and details of hospital admissions were matched from the electronic patient record of a single, tertiary paediatric hospital. Dosage which would be given according to age-banded dosing was then compared with their weight.
All children admitted to a single tertiary children's hospital aged 3 months to 16 years over a 5-year period. Data were cleaned to remove values likely to be erroneous and filtered to reduce bias due to patients who were admitted on multiple occasions.
The main outcome was the proportion of patients who would receive a subtherapeutic or supratherapeutic paracetamol dose if given a dose based on their age. Secondary outcomes were to examine this in children of different ages and to examine the impact of alternative size-based dosing strategies.
100 047 admissions (in 68 310 patients) had a weight documented. If age-banded dosing had been used, a subtherapeutic dose (less than 10 mg/kg) would be given during 19 829 (20%) of the admissions and a supratherapeutic dose (over 18.75 mg/kg, 75 mg/kg/day in four doses) in 4289 (4.3%). The highest risk of a subtherapeutic dose occurred in infants just prior to reaching 6 months of age (83%) and in children just prior to reaching 8 years (66%). The highest risk of a supratherapeutic dose was at 12 years of age (35%).
Age-banded dosing is not suitable for an inpatient paediatric population as approximately a quarter of patients receive a dose outside the recommended range of 10.0-18.75 mg/kg.
通过确定剂量落在治疗范围（按体重）之外的患者比例，评估儿科住院患者的年龄分组剂量。
回顾性观察性研究。从一家三级儿科医院的电子患者记录中匹配体重和身高测量值以及住院详细信息。然后将根据年龄分组剂量给予的剂量与他们的体重进行比较。
在五年期间，所有入住一家三级儿童医院的年龄在 3 个月至 16 岁的儿童。对数据进行清理以去除可能存在错误的值，并进行筛选以减少因多次入院的患者而产生的偏差。
主要结果是如果根据年龄给予剂量，将有多少患者接受低于或高于治疗剂量的扑热息痛剂量。次要结果是检查不同年龄的儿童，以及检查替代基于体型的剂量策略的影响。
100047 次入院（涉及 68310 名患者）记录了体重。如果使用年龄分组剂量，在 19829 次（20%）入院中会给予低于 10mg/kg 的低剂量，在 4289 次（4.3%）入院中会给予超过 18.75mg/kg（4 次剂量 75mg/kg/天）的高剂量。低剂量风险最高的是刚满 6 个月的婴儿（83%）和刚满 8 岁的儿童（66%）。高剂量风险最高的是 12 岁（35%）。
年龄分组剂量不适合住院儿科患者，因为大约四分之一的患者接受的剂量不在推荐的 10.0-18.75mg/kg 范围内。
