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Accuracy of weight estimation methods in adults, adolescents and children: a prospective study

Giles N Cattermole1,2, Appolinaire Manirafasha3,4

  • 1Department of Anaesthesia, Critical Care and Emergency Medicine, University of Rwanda College of Medicine and Health Sciences, Kigali, Rwanda giles@cattermole.org.uk.

Emergency Medicine Journal : EMJ
|September 18, 2020
PubMed

Insights

Accurate weight estimation is crucial in emergencies. The PAWPER XL-MAC tape and patient/guardian estimates proved most reliable for all age groups, outperforming traditional methods.

Area of Science:

  • Emergency Medicine
  • Clinical Assessment
  • Global Health

Background:

  • Accurate patient weight estimation is vital in emergency and low-resource settings.
  • Existing paediatric weight estimation methods like PAWPER and Mercy tapes lack validation in adults.
  • Standardized adult weight estimation methods are currently unavailable.

Purpose of the Study:

  • To evaluate the accuracy of various weight estimation methods across all age groups (paediatric, adolescent, adult).
  • To compare the efficacy of PAWPER and Mercy tape methods against direct estimates in a diverse patient population.
  • To identify the most reliable methods for weight estimation in settings where direct weighing is not feasible.

Main Methods:

  • Prospective recruitment of 947 participants (307 children, 309 adolescents, 331 adults) in Kigali, Rwanda.
  • Weight estimation using PAWPER (height & MAC) and Mercy (MAC & humeral length) methods.
  • Comparison of estimated weights against actual weights, with primary outcome as proportion within 20% (p20).

Main Results:

  • PAWPER XL-MAC and guardian/participant estimates demonstrated high accuracy across all age groups.
  • In children, guardian estimates (90.2%) and PAWPER XL-MAC (89.3%) were most accurate.
  • In adults, participant estimates (98.5%) and PAWPER XL-MAC (83.7%) showed the best performance.

Conclusions:

  • PAWPER XL-MAC and guardian/participant weight estimates are reliable for all ages in emergency/low-resource settings.
  • Traditional age-based formulae performed poorly in children.
  • This study provides the first adult validation of PAWPER and Mercy methods, recommending their clinical use.
Abstract

Keywords:
global healthpaediatricsresuscitation

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