Bedside Method to Estimate Actual Body Weight in the Emergency Department

Abstract

, Abstract-Background: Actual body weight (ABW) is important for accurate drug dosing in emergency settings. Oftentimes, patients are unable to stand to be weighed accurately or clearly state their most recent weight. Objective: Develop a bedside method to estimate ABW using simple anthropometric measurements. Methods: Prospective, blinded, cross-sectional convenience sampling of adult Emergency Department (ED) patients. A multiple linear regression equation from Derivation Phase (n = 208: 121 males, 87 females) found abdominal and thigh circumferences (AC and TC) had the best fit and an inter-rater correlation of 0.99 and 0.96, respectively: Male ABW (kg) = À47.8 + 0.78 * (AC) + 1.06 * (TC); Female ABW = À40.2 + 0.47 * (AC) + 1.30 * (TC). Results: Derivation phase: Number of patients (%) with a body weight estimation (BWE) > 10 kg from ABW for males/females were: 7 (6%)/1 (1%) for Patients, 46 (38%)/28 (32%) for Doctors, 38 (31%)/24 (27%) for Nurses, 75 (62%)/43 (49%) for 70 kg/60 kg convention, and 14 (12%)/8 (9%) using the anthropometric regression model. For validation phase (55 males, 44 females): Gold standard ABW mean (SD) male/female = 83.6 kg (14.3)/71.5 kg (18.9) vs. anthropometric regression model = 86.3 kg (14.7)/73.3 kg (15.1). R 2 = 0.89, p < 0.001. The number (%) for males/females with a BWE > 10 kg using the anthropometric regression model = 8 (15%)/11 (27%). Conclusions: For male patients, a regression model using supine thigh and abdominal circumference measurements seems to provide a useful and more accurate alternative to physician, nurse, or standard 70-kg male conventional estimates, but was less accurate for use in female patients. Ó 2011 Elsevier Inc.

The influence of hypophosphatemia on outcomes of low- and high-intensity continuous renal replacement therapy in critically ill patients with acute kidney injury

“…A third limitation of this study was that because body weight was not measurable due to patient condition, body weight was estimated based on usual body weight, venous pressure, X-ray findings, and the difference between total input and output. Other methods to estimate actual body weight in an emergency setting include abdominal and thigh circumference [ 28 ]. The use of such anthropometric measurements in the future could potentially prove useful to accurately predict a patient’s weight, improve drug dosing, and reduce the number of medication errors.…”

Difference in perceived knowledge, confidence and attitudes between dietitians and other health professionals in the provision of weight management advice

“…From the results, it is clear that both dietitians and HPs have equal exposure to overweight and obese clients in their treatment groups and feel that it is within their scope of practice to provide weight management advice as part of their interaction with the client. However, there is evidence that when using visual assessment methods as described by the HPs, instead of recognised tools such as measured weight (kg), medical practitioners have difficulty estimating body weight . In these circumstances, body weight is often under estimated and obesity would be under‐identified.…”

“…However, there is evidence that when using visual assessment methods as described by the HPs, instead of recognised tools such as measured weight (kg), medical practitioners have difficulty estimating body weight . In these circumstances, body weight is often under estimated and obesity would be under‐identified. Therefore, it is possible that HPs are seeing more obese patients, requiring them to be confident and competent in both assessment and first‐line obesity management advice.…”

Adult weight measurement: decoding the terminology used in literature

“…6 The most commonly used equations that could be used to calculate body weight in an adult have been summarised in Table 1. 7-9 These equations have not been validated for use in a South African population. Table 1 describes possible equations that could be used to calculate EBW.…”