Body surface area prediction in normal-weight and obese patients

None of the equations frequently used to predict body surface area (BSA) has been validated for obese patients. We applied the principles of body size scaling to derive an improved equation predicting BSA solely from a patient's weight. Forty-five patients weighing from 51.3 to 248.6 kg had their height and weight measured on a calibrated scale and their BSA calculated by a geometric method. Data were combined with a large series of published BSA estimates. BSA prediction with the commonly used Du Bois equation underestimated BSA in obese patients by as much as 20%. The equation we derived to relate BSA to body weight was a power function: BSA (m(2)) = 0.1173 x Wt (kg)(0.6466). Below 10 kg, this equation deviated significantly from the BSA vs. body weight curve, necessitating a different set of coefficients: BSA (m(2)) = 0.1037 x Wt (kg)(0.6724). Covariance of height and weight for patients weighing <80 kg reduced the Du Bois BSA-predicting equation to a power function, explaining why it provides good BSA predictions for normal-size patients but fails with obesity.