Evaluation of Different Methods Used to Calculate Ideal Body Weight in the Pediatric Population

Abstract

OBJECTIVES Accurate determination of ideal body weight (IBW) in pediatric patients is important for the proper dosing of many medications and the classification of nutritional status. There is no consensus on the best method to calculate IBW. The purpose of this study is to evaluate and compare 7 different methods used to calculate IBW in the pediatric population. METHODS This was a retrospective observational study. All subjects were pediatric inpatients at a 536-bed community teaching hospital between January 1, 2016, and June 30, 2017. Subjects were divided into 2 cohorts: cohort 1 was aged 12 months and 0 day to 35 months and 30 days, and cohort 2 was aged 36 months and 0 day to 17 years and 364 days. The McLaren method was used as the reference to compare with 6 other methods: Moore method, Devine method, American Dietetic Association (ADA) method, body mass index (BMI) method, Traub equation, and simplified Traub equation. RESULTS For cohort 1 (n = 347), the Moore method was not statistically different from the McLaren method with a mean difference of −0.07 kg (95% CI: −0.14 to 0.01, p = 0.07). For cohort 2 (n = 1095), the BMI method was not statistically different from the McLaren method with a mean difference of 0.17 kg (95% CI: −0.07 to 0.40, p = 0.17). CONCLUSIONS In both cohorts, the majority of methods used to calculate IBW in pediatric patients leads to statistically different results when compared with the McLaren method. For certain methods, these differences become pronounced at high and low height percentiles and in older age groups.

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“…Adult male and female data 107,128 . Pediatric male and female data 111 . The table suggests a starting plan (first recommendation to be given) based evidence level D. These guidelines serve as starting point that require personalized adaptation.…”

“…Adult male and female data 107,112,128 . Pediatric male and female data 62,111 . The table suggests a starting plan (first recommendation to be given) that can then be personally adapted based (evidence level D.) The table provides guidance on how to adapt plans (first recommendation given in gray) based on trialing the starting plan.…”

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“…The ACR guidelines recommend using ideal body weight (IBW) for IVIG dosing.19 Ideal body weight is defined as being a reflection of lean body mass and is particularly important with the increasing rate of obesity in pediatric patients. 63 Miscalculations of medications can lead to lack of efficacy if subtherapeutic or toxicity if supratherapeutic. Kang et al63 ultimately concluded that various methods to calculate pediatric IBW lead to differences of varying statistical and clinical significance, and larger sample sizes are needed in order to determine the most accurate method for specific subgroups of varying age and height percentiles.…”