Normal axillary thickness thresholds as a metric for nutritional status of children

Childhood pneumonia is a major cause of death in the 3rd world, and undernourishment increases the severity of the condition. We considered axillary thickness as a simple measurement to evaluate nutritional status that can be performed simultaneously with lung ultrasound. Our goal was to determine the distribution of axillary thickness in a cohort of children to determine a threshold for malnutrition.

Clinical databases were scanned to identify chest computed tomograms (CT) in children between the ages of 0 and 5 years with non-debilitating disease. The bilateral axillary thicknesses of the cohort were determined using equivalent width, and these measurements were segmented by age, sex, and laterality to determine cutoff thresholds. Data was evaluated using single factor analysis of variance (ANOVA) and 5th percentile analysis to determine the lower bound thresholds of axillary thickness.

247 scans met inclusion criteria. ANOVA demonstrated no significant differences in the mean measurements in the 5 groups (p = 0.377). 95% confidence limits on the 5th percentile plots showed an axillary thickness of 1.5 cm was a reasonable threshold for malnutrition detection for all age groups and sexes except for males between 0 and 1 years old where a 1.1 cm threshold may be required.

CT scans of the chests in a cohort of children without debilitating disease revealed a remarkably uniform axillary thickness threshold for malnutrition assessment of 1.5 cm. This suggests that there may be a threshold for nutritional assessment for children undergoing lung ultrasound scans for childhood pneumonia.