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Development and validation of a novel paediatric weight estimation equation in multinational cohorts of sick children
Lindsey McVey1, David Young2, Jessie Hulst3
1Human Nutrition, School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow Royal Infirmary, Glasgow, G31 2ER, UK.
Insights
Accurate weight estimation for sick children is crucial. New Children's European Estimator of Weight (CEEW) equations, using mid-upper arm circumference, show superior accuracy compared to existing methods.
Area of Science:
- Pediatric medicine
- Clinical assessment
- Biostatistics
Background:
- Accurate weight estimation is vital for administering medication and fluid to sick children who cannot be weighed.
- Existing weight estimation equations often lack the necessary accuracy and precision for clinical use.
Purpose of the Study:
- To develop a novel, accurate weight estimation equation for sick children in Europe.
- To validate the new equation against established methods.
Main Methods:
- Developed weight estimation equations using data from 2086 sick children across the UK, Greece, and the Netherlands.
- Utilized mid-upper arm circumference (MUAC), demographics, and height measurements.
- Compared the novel Children's European Estimator of Weight (CEEW) equations against ERC, APLS, and Cattermole equations.
Main Results:
- Two CEEW equations (CEEW1 with height, CEEW2 without) were developed, incorporating age, gender, and MUAC.
- Both CEEW equations demonstrated high coefficients of determination (R² > 96.5%) and minimal prediction error.
- CEEW1 achieved 88% accuracy within 15% of measured weight, significantly outperforming comparator equations (max 57%).
Conclusions:
- The CEEW equations offer substantially improved accuracy for weight estimation in sick children compared to current standards.
- The developed equations provide a more reliable tool for clinical practice.
- A mobile application for CEEW is available.
Aim:
In sick children who are unable to be weighed estimation of weight is often required, but the routinely used equations lack accuracy and precision. This study aimed to develop a novel equation (Children's European Estimator of Weight-CEEW) using measurements of mid-upper arm circumference (MUAC) and other predictors in multinational groups of sick children in Europe.
Methods:
Weight estimation equations were developed in 2086 children from the UK, Greece and the Netherlands, using a combination of demographics, MUAC and height measurements. The final CEEW equations were compared against the performance of the European Resuscitation Council (ERC), Advanced Paediatric Life Support (APLS) and the Cattermole equations.
Results:
Two final CEEW equations were developed, incorporating measurements of age, gender and MUAC, with (CEEW1) or without (CEEW2) the inclusion of height. Both equations presented very high coefficients of determination (R2>96.5%), minimal mean prediction error and narrower limits of agreement than the comparator equations. 88% (CEEW1) and 77% (CEEW2) of weight estimates fell within 15% of measured body weight. These figures compared with less than 57%, 57% and 37% for the ERC, APLS and Cattermole equations respectively.
Conclusion:
The CEEW equations performed substantially better than other routinely used equations for weight estimation. An electronic application for mobile use is presented.
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