Desarrollo y validación de una fórmula de estimación del peso para emergencias pediátricas / Development and validation of a weight estimation tool for paediatric emergency care

OBJETIVOS: Desarrollar y validar una herramienta de estimación del peso en emergencias pediátricas. MÉTODO: Estudio realizado en 2 etapas. Utilizando datos antropométricos informatizados de los servicios de pediatría de atención primaria de Bilbao (País Vasco, España) se elaboraron modelos de regresión lineal para estimar el peso en función de la estatura. Posteriormente, estos modelos fueron aplicados de forma prospectiva a una muestra consecutiva de pacientes pediátricos atendidos en urgencias de 2 hospitales terciarios. Se compararon los pesos estimados con los reales, calculando el coeficiente de correlación intraclase (CCI), media de la diferencia y proporción de mediciones con un error del peso estimado inferior al 10 y 20% con respecto al valor real. RESULTADOS: A partir de los datos antropométricos de 15.522 menores se desarrollaron 2 fórmulas predictivas del peso («fórmulas de Bilbao»). Las formulas fueron validadas sobre una muestra de 780 pacientes pediátricos, y estimaron valores del peso con un alto grado de correlación intraclase con respecto al peso real (CCI=0,93; p < 0,001) y una media de la diferencia de 0,63 (DE: 4,3). La proporción de error de la estimación del peso con respecto al valor real fue inferior al 10 en el 62,2% (IC 95%: 58,7-65,6) de las mediciones e inferior al 20% en el 93,1% (IC 95%: 91,1-94,8), unos resultados notablemente mejores que los que hubiesen obtenido otras fórmulas clásicas. CONCLUSIONES: Las «fórmulas de Bilbao» pueden suponer una herramienta válida en la estimación del peso en pacientes pediátricos en urgencias y predicen el peso con mayor precisión que otras fórmulas de uso más habitual basadas en la edad

OBJECTIVE: To develop and validate a weight estimation tool applicable in paediatric emergency care. METHODS: Using anthropometric data from a computerized database of the primary health care paediatric services, Bilbao (Basque Country, Spain), linear regression models were developed with the objective of estimating weight from height. Subsequently, these models were prospectively validated using a consecutive sample of children attended in the emergency department of two tertiary hospitals. Estimated weights were compared with actual weights, calculating the intraclass correlation coefficient (ICC), mean difference and percentages of estimations falling within 10% and 20% of the actual weight. RESULTS: Using anthropometric data from 15522 children two weight predictive formulas were developed (Bilbao Formulas). The formulas were validated on a sample of 780 children and estimated weight values with a high degree of intraclass correlation with the real weight (ICC=.93, P<.001) and a mean difference of .63 (SD: 4.3). The percentages of estimations falling within 10% and 20% of the actual weight of the child was 62.2% (95% CI: 58.7-65.6) and 93.1% (95% CI: 91.1-94.8), respectively. Weight estimations were more accurate using Bilbao Formulas than other classical formulas. CONCLUSIONS: Bilbao Formulas would be a valid tool for estimating weight in children in the emergency department and predict weight more accurately than other more commonly used age-based formulas

Development and validation of a weight estimation tool for paediatric emergency care. / Desarrollo y validación de una fórmula de estimación del peso para emergencias pediátricas.

OBJECTIVE: To develop and validate a weight estimation tool applicable in paediatric emergency care. METHODS: Using anthropometric data from a computerized database of the primary health care paediatric services, Bilbao (Basque Country, Spain), linear regression models were developed with the objective of estimating weight from height. Subsequently, these models were prospectively validated using a consecutive sample of children attended in the emergency department of two tertiary hospitals. Estimated weights were compared with actual weights, calculating the intraclass correlation coefficient (ICC), mean difference and percentages of estimations falling within 10% and 20% of the actual weight. RESULTS: Using anthropometric data from 15522 children two weight predictive formulas were developed (Bilbao Formulas). The formulas were validated on a sample of 780 children and estimated weight values with a high degree of intraclass correlation with the real weight (ICC=.93, P<.001) and a mean difference of .63 (SD: 4.3). The percentages of estimations falling within 10% and 20% of the actual weight of the child was 62.2% (95% CI: 58.7-65.6) and 93.1% (95% CI: 91.1-94.8), respectively. Weight estimations were more accurate using Bilbao Formulas than other classical formulas. CONCLUSIONS: Bilbao Formulas would be a valid tool for estimating weight in children in the emergency department and predict weight more accurately than other more commonly used age-based formulas.

Validez de las estrategias de estimación de peso en pacientes pediátricos atendidos en urgencias / Validity of approaches to estimating weight in children attended in the emergency department

Objetivos: Validar distintos métodos destinados a estimar el peso en pacientes pediátricos en urgencias. Metodología: Serie de casos prospectivo con análisis transversal en pacientes de 1 mes hasta 14 años de edad en dos hospitales terciarios en el País Vasco (España). Se aplicaron 9 herramientas distintas de estimación de peso y se comparó el resultado con el peso real, calculando índices de concordancia (CCI), media de la diferencia y proporción de mediciones con un error del peso estimado inferior al 10% y 20% con respecto al peso real. Resultados: Se realizaron mediciones en 515 pacientes pediátricos. Todas las estimaciones presentaron una alta concordancia con respecto al peso real. La estimación parental del peso resultó la estrategia con menor margen de error (86,5% de mediciones con error < 10%), seguida de la Regla RCP del Hospital del Niño Jesús (63,5% de mediciones con error <10%). Las fórmulas de estimación basadas en edad o antropometría no ofrecieron proporciones superiores al 40% de mediciones con un error < 10%. Conclusiones: La estimación parental es una herramienta válida para la estimación del peso en niños. Cuando no está disponible esa opción, la Regla de RCP del Hospital del Niño Jesús sería la herramienta de elección

Objectives: To determine the validity of different ways of estimating body weight in children attended in the emergency department. Methods: Prospective cross-sectional study of a series of patients between 1 month and 14 years of age attended in 2 tertiary care hospitals in the Basque Country, Spain. We used 9 different ways to estimate body weight and compared the estimates to real weight by calculating the mean intraclass correlation coefficient, the mean difference between real and estimated weights, and the proportion of measurements within 10% and 20% of the real weight. Results: Five hundred fifteen pediatric patients were weighed and their weights estimated. All estimates had a high degree of agreement with real weight. A parent's weight estimate performed best: 86.5% of parental estimates were within 10% of the real weight. The next best estimate was achieved with the cardiopulmonary resuscitation (CPR) rule developed at Hospital del Niño Jesús: 65% of the estimates were within the 10% margin. Fewer than 40% of the weight estimates based on formulas using anthropometric measurements were within the 10% margin. Conclusions: A parent's estimate of weight is a valid approximation in children of all ages. When this estimate is not available, the CPR rule of Hospital del Niño Jesús would be the method of choice

Validity of approaches to estimating weight in children attended in the emergency department. / Validez de las estrategias de estimación de peso en pacientes pediátricos atendidos en urgencias.

OBJECTIVES: To determine the validity of different ways of estimating body weight in children attended in the emergency department. MATERIAL AND METHODS: Prospective cross-sectional study of a series of patients between 1 month and 14 years of age attended in 2 tertiary care hospitals in the Basque Country, Spain. We used 9 different ways to estimate body weight and compared the estimates to real weight by calculating the mean intraclass correlation coefficient, the mean difference between real and estimated weights, and the proportion of measurements within 10% and 20% of the real weight. RESULTS: Five hundred fifteen pediatric patients were weighed and their weights estimated. All estimates had a high degree of agreement with real weight. A parent's weight estimate performed best: 86.5% of parental estimates were within 10% of the real weight. The next best estimate was achieved with the cardiopulmonary resuscitation (CPR) rule developed at Hospital del Niño Jesús: 65% of the estimates were within the 10% margin. Fewer than 40% of the weight estimates based on formulas using anthropometric measurements were within the 10% margin. CONCLUSION: A parent's estimate of weight is a valid approximation in children of all ages. When this estimate is not available, the CPR rule of Hospital del Niño Jesús would be the method of choice.

OBJETIVO: Validar distintos métodos destinados a estimar el peso en pacientes pediátricos en urgencias. METODO: Serie de casos prospectivo con análisis transversal en pacientes de 1 mes hasta 14 años de edad en dos hospitales terciarios en el País Vasco (España). Se aplicaron 9 herramientas distintas de estimación de peso y se comparó el resultado con el peso real, calculando índices de concordancia (CCI), media de la diferencia y proporción de mediciones con un error del peso estimado inferior al 10% y 20% con respecto al peso real. RESULTADOS: Se realizaron mediciones en 515 pacientes pediátricos. Todas las estimaciones presentaron una alta concordancia con respecto al peso real. La estimación parental del peso resultó la estrategia con menor margen de error (86,5% de mediciones con error < 10%), seguida de la Regla RCP del Hospital del Niño Jesús (63,5% de mediciones con error <10%). Las fórmulas de estimación basadas en edad o antropometría no ofrecieron proporciones superiores al 40% de mediciones con un error < 10%. CONCLUSIONES: La estimación parental es una herramienta válida para la estimación del peso en niños. Cuando no está disponible esa opción, la Regla de RCP del Hospital del Niño Jesús sería la herramienta de elección.