Weight estimation in paediatrics: a comparison of the APLS formula and the formula 'Weight=3(age)+7'

Emerg Med J. 2011 Jul;28(7):590-3. doi: 10.1136/emj.2009.087288. Epub 2010 Jul 20.

Abstract

Objectives: To gather data on the ages and weights of children aged between 1 and 16 years in order to assess the validity of the current weight estimation formula 'Weight(kg)=2(age+4)' and the newly derived formula 'Weight=3(age)+7'.

Design: Retrospective study using data collected from paediatric attendances at an emergency department (ED).

Setting: A large paediatric ED in a major UK city.

Patients: 93,827 children aged 1-16 years attending the ED between June 2003 and September 2008.

Main outcome measures: Percentage weight difference between the child's actual weight and the expected weight, the latter determined by 'Weight(kg)=2(age+4)' and by 'Weight(kg)=3(age)+7', in order to compare these two formulae.

Results: The weights of seriously ill children were recorded in only 20.5% of cases, necessitating a weight estimate in the remainder. The formula 'Weight=2(age+4)' underestimated children's weights by a mean of 33.4% (95% CI 33.2% to 33.6%) over the age range 1-16 years whereas the formula 'Weight=3(age)+7' provided a mean underestimate of 6.9% (95% CI 6.8% to 7.1%). The formula 'Weight=3(age)+7' remains applicable from 1 to 13 years inclusive.

Conclusions: Weight estimation is of paramount importance in paediatric resuscitation. This study shows that the current estimation formula provides a significant underestimate of children's weights. When used to calculate drug and fluid dosages, this may lead to the under-resuscitation of a critically ill child. The formula 'Weight=3(age)+7' can be used over a larger age range (from 1 year to puberty) and allows a safe and more accurate estimate of the weight of children today.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age Factors
  • Algorithms
  • Body Weight*
  • Child
  • Child, Preschool
  • Emergency Service, Hospital
  • Female
  • Humans
  • Infant
  • Male
  • Pediatrics / methods*
  • Resuscitation / methods
  • Retrospective Studies
  • United Kingdom