Age-based Estimation Research Articles

An anthropometric evidence against the use of age-based estimation of bodyweight in pediatric patients admitted to intensive care units

Age-based bodyweight estimation is commonly used in pediatric settings, but pediatric ICU patients often have preexisting comorbidity and resulting failure to thrive, hence their anthropometric measures may be small-for-age. Accordingly, age-based methods could overestimate bodyweight in such settings, resulting in iatrogenic complications. We performed a retrospective cohort study using pediatric data (aged < 16 years) registered in the Japanese Intensive Care Patient Database from April 2015 to March 2020. All the anthropometric data were overlaid on the growth charts. The estimation accuracy of 4 age-based and 2 height-based bodyweight estimations was evaluated by the Bland–Altman plot analysis and the proportion of estimates within 10% of the measured weight (ρ10%). We analyzed 6616 records. The distributions of both bodyweight and height were drifted to the lower values throughout the childhood while the distribution of BMI was similar to the general healthy children. The accuracy in bodyweight estimation with age-based formulae was inferior to that with height-based methods. These data demonstrated that the pediatric patients in the Japanese ICU were proportionally small-for-age, suggesting a special risk of using the conventional age-based estimation but supporting the use of height-based estimation of the bodyweight in the pediatric ICU.

Comparison of lethal and non-lethal age-based growth estimation methodologies to assess an endemic bay population of Atlantic cod (Gadus morhua)

The Gilbert Bay, Labrador, MPA (Marine Protected Area) was created in 2005 to protect a genomically distinct and locally adapted bay resident population of Atlantic cod (Gadus morhua) from commercial overfishing. Since then research showed that significant numbers of individuals migrate beyond MPA boundaries creating a concern that fishing continues to impact this endemic population. As part of research and MPA monitoring to assess the health of the protected cod population, lethal sampling of Gilbert Bay cod was conducted from 1998 to 2009 to gather length-at-age data from otoliths. Since then only non-lethal sampling methods were used so as to help conserve the protected population. This study was conducted to compare non-lethally (mark-recapture and length-frequency) obtained age and growth data with lethally (otolith-length-at-age) obtained data. The three methods produced similar results for the 1998 to 2009 period, and both of the non-lethal methods considered were consistent over the 20 year study, confirming their preference over lethal methods for this small endemic fish population.

Application of Weight Estimation Formula in Emergency for Pakistani Pediatric Polulation: Advanced Pediatric Life Support or Luscombe

Objectives: To compare original Advanced Pediatric Life Support (APLS) and Luscombe &amp; Owen (LO) formula with weight on scale in Pakistani pediatric population.&#x0D; Study Design: Comparative cross-sectional study.&#x0D; Place and Duration of Study: Pediatric Unit, Pak Emirates Military Hospital Rawalpindi Pakistan, from Jan to Jun 2018.&#x0D; Methodology: A total of 1059 patients were subjected to weight scale and different formulas for weight estimation i.e., original APLS and LO. A pre-designed Performa was used to extract the data. SPSS v.25.0 was used as statistical analysis, where t-test was used to measure the significant difference.&#x0D; Results: The mean age of 1059 children was 4.55 ± 2.96 years with 55.1% males and 44.9% females. A total of 683 (64.4%) children were below or of 5 years of age. The mean scale weight was recorded as 16.71 ± 6.34 kg while for APLS and LO estimation mean was 17.13 ± 5.935 kg and 20.62 ± 8.88 kg respectively. The difference in means of scale weight with APLS and LO estimation was -0.42 kg and -3.92 kg respectively. Independent sample t-test was used for comparison of scale weight with original APLS and LO, p-value of 0.115 and &lt;0.001 were recorded for both respectively, revealing that no difference in means of scale weight and APLS.&#x0D; Conclusion: Pakistani pediatric population of young age utilizing age-based estimation methods, APLS weight estimation tool is much better than LO estimation.

Age-based Estimation of Contact Lens Base Curve in Filipino Infants

Objective. To create an age-based formula to estimate the base curve needed for contact lens fitting using measured central corneal curvature (CCC) with a handheld auto keratometer from ophthalmologically normal infants. Methods. This is a prospective cross-sectional study involving 70 ophthalmologically normal full-term infants aged 0 to 12 months. The infants were divided into four groups: 0–3 months, &gt;3–6 months, &gt;6–9 months and &gt;9–12 months. CCC was measured with a handheld auto keratometer and was used to compute for the base curve. Differences in CCC between the four groups were measured and linear regression models were used for formula creation. Results. The mean CCC was highest in group 1 at 45.5 ±2.4 diopters (D). These values slowly decreased as age increased. A formula predictive of the base curve based on the infants age was derived using linear regression analysis. It predicted that for every month increase in age, there is a 0.063 millimeter increase in the base curve (p&lt;0.001). Conclusion. Infant CCC is highest at birth and gradually decreases as age increases. The formula can predict the base curve needed for contact lens fitting in infants without the need for a handheld autokeratometer.

Validation of the mid-arm-based weight estimation formula (the Cattermole formula) for Korean children

BackgroundA mid-arm circumference-based weight estimation formula has recently been proposed. The Cattermole formula, which is suggested for children aged 1–11 years, is calculated as (mid-arm circumference in cm − 10) × 3 kg. The objective of this study was to externally validate the Cattermole formula using a Korean national survey database. MethodsThe data collected from a national survey conducted in 2005 by the Korean Pediatric Society included body weight, height, age and mid-arm circumference. To determine whether the Cattermole formula accurately predicted the actual weights of Korean children, we compared the performance of the Cattermole formula with those of other age-based and height-based weight estimation methods. ResultsA total of 91,147 children aged 1–11 years were assessed for eligibility. The mean age was 5.3 years, and 52.6% of the children were boys. The mean measured weight was 22.4 kg, and the mean mid-arm circumference was 17.9 cm. The Cattermole formula resulted in a mean difference of 1.35 kg and a mean percentage error of 11.5% with 95% limits of agreement of −8.1 to +10.8. A total of 37.9% of the estimates were within 10% of the measured weights. ConclusionAcross all ages, the Cattermole formula was not more accurate than the other methods. However, in children older than 6 years, the Cattermole formula results were more accurate than those of the age-based formulae with the exception of the Broselow tape. Clinical trial registrationNone.

Predicting endotracheal tube size from length: Evaluation of the Broselow tape in Indian children

Background and Aims:Several formulae are available to estimate endotracheal tube (ETT) size in children. This study was designed to compare the ETT estimated by the Broselow tape (BT) with age-based estimation of ETT size and to identify the most accurate formula for the prediction of uncuffed ETT size in Indian children.Material and Methods:Pediatric patients aged 1 month–6.5 years undergoing emergency or elective surgery under general anesthesia requiring endotracheal intubation with uncuffed ETT were included in this study. The ETT size was selected based on the age formula (Penlington formula). The ETT used was deemed to be of correct fit based on the delivery of adequate tidal volume and presence of minimal leak at 20 cm H2O. The actual ETT used was compared with that predicted by age, length of the child, BT, and fifth fingernail width of the child using Pearson's correlation.Results:In children aged <6 months, the ETT used was found to correlate with length (r = 0.286, P = 0.044) and finger nail width (r = 0.542, P < 0.001) of the children. In children >6 months, the ETT used correlated with that predicted from age, BT, length, and fingernail width of the children. In our study, BT has an overall correct predictability rate of 50.3% whereas the age-based formula has a correct prediction rate of 59.8% and length-based formula is 48.7% accurate.Conclusion:Length of the child has a good correlation with size of the ETT to be used in Indian children across all age groups. BT is an effective tool to predict ETT size in children >6 months.

Weight estimation in paediatric resuscitation: A hefty issue in New Zealand.

To test the accuracy of weight estimation methods currently used in New Zealand to predict a child's weight in emergency resuscitation. A prospective, observational study. Data were collected in July 2013 at five Auckland schools among children aged 5-10 years. Collected demographic information included age, ethnicity, sex and school decile. Standardised measures included weight, height and Broselow-Luten tape (2011 version, limited to children 43-143 cm) weight. Age-based weight estimates were calculated for APLS, Shann and Theron formulae. Mean bias (actual weight - estimated weight) and clinical accuracy (proportion of estimates within 10% of actual weight) are reported. Bland-Altman plots illustrate agreement and 95% limits of agreement. The 376 participants weighed between 14.2 and 93.1 kg. The proportion of weight estimates within 10% of actual weight were 28.7%, 39.1% and 45.7% for the age-based formula (Theron, APLS and Shann, respectively). The mean bias was negative for Theron (-6.5) and positive for APLS (7.8) and Shann (7.7). For the length-based Broselow-Luten tape method (n = 305), the proportion of weight estimates within 10% of actual weight was 73.4% and mean bias was 1.1. For children under 143 cm in height, the Broselow-Luten tape outperforms other weight estimation methods, accurately estimating weight in approximately three out of four children. The age-based estimation methods performed poorly overall, with variation by age and ethnicity.

Variability of Resting Energy Expenditure in Infants and Young Children With Intestinal Failure–Associated Liver Disease

The aim of the study was to determine, in a cohort of young children with intestinal failure (IF), whether the estimates of basal metabolic rate (BMR) by standard equations can approximate measured resting energy expenditure (REE) by indirect calorimetry (IC). IC was performed using the dilutional canopy technique. REE measurements were compared with standard, age-based estimation equations (World Health Organization) for BMR. Subjects were classified as hypermetabolic (REE > 110% BMR), hypometabolic (REE < 90% BMR), or normal (REE = 90%-110% BMR). Twenty-eight IF patients (11 girls, 17 boys) had an underlying diagnosis of necrotizing enterocolitis (n = 10) or a congenital gastrointestinal defect (n = 18). Median age was 5.3 months. Median interquartile range (IQR) REE was 46 (42-58) kcal · kg · day. Median (IQR) total energy intake provided 209% (172%-257%) of REE, with parenteral nutrition providing 76% (23%) of total energy intake. REE was variable, with 39% (n = 11) of measurements hypermetabolic, 39% (n = 11) hypometabolic, and the remaining 21% (n = 6) normal. Although REE was well correlated with estimated BMR (r = 0.82, P < 0.0001), estimated BMR was not consistently an adequate predictor of REE. BMR over- or underestimated REE by >10 kcal · kg · day in 15 of 28 (54%) patients. REE was not significantly correlated with severity of liver disease, nutritional status, total energy intake, or gestational age. Energy expenditure is variable among children with IF and IF-associated liver disease, with approximately 80% of our cohort exhibiting either hypo- or hypermetabolism. Standard estimation equations frequently do not correctly predict individual REE. Longitudinal studies of energy expenditure and body composition may be needed to guide provision of nutrition regimens.

CORKSCREW 2013 CORK study of children's realistic estimation of weight

BackgroundIn a resuscitation situation involving a child (age 1–15 years) it is crucial to obtain a weight as most interventions and management depend on it. The APLS formula, ‘2×(age+4)’, is...

A comparison of actual to estimated weights in Australian children attending a tertiary children's’ hospital, using the original and updated APLS, Luscombe and Owens, Best Guess formulae and the Broselow tape

IntroductionDuring paediatric resuscitation it is essential to be able to estimate the child's weight as it determines drug doses and equipment sizes. Age and length-based estimations exist, with age-based estimations being especially useful in the preparation phase and the length-based Broselow tape having weight-based drug doses and equipment already assigned via a colour code system. The aim of this study was to compare the actual recorded weights of Australian children to the predicted weights using the original and updated APLS, Luscombe and Owens and Best Guess formulae and the Broselow tape. MethodA retrospective observational study of children attending an Australian tertiary children's hospital. ResultsFrom 49,565 patients extracted from the database, 37,114 children with age and weight and 37,091 children with age and height recorded were included in the analysis. Best Guess was the most accurate, with the smallest overall mean difference 0.86kg. For <1 year old, Broselow tape was the most accurate (mean difference −0.43kg), Best Guess was the most accurate for ages 1–5 years and 11–14 years (mean difference 0.27 and 0.20kg respectively), and the updated APLS formula was the most accurate for 6–10 year-old (mean difference 0.42kg). The Broselow tape was able to only classify 48.9% of children into the correct weight colour band. ConclusionsFor an age-based weight estimation, in infants less than one year the new APLS formula is the most accurate and over one year the Best Guess formulae should be used.