Ahmad Bashir, Islam Fahad, Ansari Muhammad Imran, Taimoor Lalarukh, Arif Muhammad Sohaib, Ur Rehman Memon Aziz, Umair Madiha, Abubaker Jawed
National Institute of Cardiovascular Diseases, Karachi, Sindh, Pakistan
National Institute of Cardiovascular Diseases, Karachi, Sindh, Pakistan.
BMJ Open. 2025 Sep 15;15(9):e102507. doi: 10.1136/bmjopen-2025-102507.
In critical care, intensive care unit (ICU) staff and physicians often estimate patients' height and weight visually, impacting calculations for cardiac function, ventilation, medication, nutrition and renal function. However, accurate assessment is challenging in critically ill patients. This study evaluates the accuracy of visual estimations by ICU staff.
Descriptive cross-sectional study.
National Institute of Cardiovascular Diseases, Karachi, Pakistan.
We included a convenient sample of adult (≥18 years) cardiac patients admitted to the critical care unit in this study. Patients who refused to give consent, trauma/surgery of lower limbs or patients with below-knee or above-knee amputation were excluded to avoid bias.
A convenient sample of cardiac ICU patients was included. Measured weight (kg) and height (cm) were compared with visual estimations by senior ICU nurse, senior non-ICU nurse, ICU consultants, fellows and residents. Correlation and agreement were analysed using Bland-Altman plots and 95% agreement limits.
A total of 356 patients were evaluated, of whom 204 (57.3%) were male, with a mean age of 55.2 ± 14.3 years. The median SOFA score was 3 [2-5], and 101 patients (28.4%) were on mechanical ventilation. The mean difference between measured and estimated weight by senior non-ICU nurse was 4.7±9.2 [-13.38-22.83] kg, senior ICU nurse was 7.8±9.9 [-11.56-27.12] kg, ICU consultants was 3.0±6.6 [-9.89-15.79] kg, ICU fellow was 3.0±7.1 [-10.88-16.92] kg and ICU resident was 8.0±9.6 [-10.83-26.79] kg. Similarly, the mean difference between measured and estimated height by senior non-ICU nurse was 2.0±7.3 [-12.36-16.34] cm, senior ICU nurse was 2.4±7.5 [-12.19-17.00] cm, ICU consultants was 1.5±5.6 [-9.51-12.48] cm, ICU fellow was 1.1±5.5 [-9.68-11.95] cm and ICU resident was 2.3±8.5 [-14.40-19.01] cm.
The findings indicate that healthcare professionals tend to overestimate both weight and height. The accuracy of these estimations varied among professional groups, underscoring the potential clinical consequences of such errors. This emphasises the need for objective measurements in clinical decision-making.
在重症监护中，重症监护病房（ICU）的工作人员和医生常常通过目测来估计患者的身高和体重，这会影响心脏功能、通气、用药、营养及肾功能的计算。然而，对危重症患者进行准确评估具有挑战性。本研究评估了ICU工作人员目测估计的准确性。
描述性横断面研究。
巴基斯坦卡拉奇国家心血管病研究所。
本研究纳入了入住重症监护病房的成年（≥18岁）心脏病患者的便利样本。拒绝给予同意的患者、下肢创伤/手术患者或膝下或膝上截肢患者被排除，以避免偏差。
纳入了心脏ICU患者的便利样本。将测量的体重（kg）和身高（cm）与高级ICU护士、高级非ICU护士、ICU顾问、研究员和住院医师的目测估计值进行比较。使用布兰德-奥特曼图和95%一致性界限分析相关性和一致性。
共评估了356例患者，其中204例（57.3%）为男性，平均年龄为55.2±14.3岁。序贯器官衰竭评估（SOFA）评分中位数为3[2 - 5]，101例患者（28.4%）接受机械通气。高级非ICU护士测量体重与估计体重的平均差值为4.7±9.2[-13.38 - 22.83]kg，高级ICU护士为7.8±9.9[-11.56 - 27.12]kg，ICU顾问为3.0±6.6[-9.89 - 15.79]kg，ICU研究员为3.0±7.1[-10.88 - 16.92]kg，ICU住院医师为8.0±9.6[-10.83 - 26.79]kg。同样，高级非ICU护士测量身高与估计身高的平均差值为2.0±7.3[-12.36 - 16.34]cm，高级ICU护士为2.4±7.5[-12.19 - 17.00]cm，ICU顾问为1.5±5.6[-9.51 - 12.48]cm，ICU研究员为1.1±5.5[-9.68 - 11.95]cm，ICU住院医师为2.3±8.5[-14.40 - 19.01]cm。
研究结果表明，医护人员往往会高估体重和身高。这些估计的准确性在不同专业组之间存在差异，凸显了此类误差可能产生的临床后果。这强调了在临床决策中进行客观测量的必要性。
