• Giles N Cattermole and Mike Wells.
• Department of Emergency Medicine King's College Hospital National Health Service Trust London UK.
• J Am Coll Emerg Physicians Open. 2021 Aug 1; 2 (4): e12515.

ObjectiveMany emergency drug and fluid doses are weight dependent in adults, but in resuscitation and low-resource settings it can be impractical or impossible to weigh a patient. It is especially important to obtain accurate weight estimation for dose calculations for emergency drugs with narrow therapeutic ranges. Several weight estimation methods have been proposed for use in adults, but none is widely established. The aim of this study was to compare the accuracy of adult weight estimation methods.MethodsDemographic and body measurement data were obtained from the US National Health and Nutrition Examination Survey (NHANES), and 7 previously published weight estimation methods were used to estimate the weight for each individual. The primary outcomes were the proportions of estimates within 10% and 20% of actual weight (P10, P20). An acceptable accuracy was predetermined to be P10 = 70% and P20 = 95%.ResultsThe data set included 5158 adults (51.2% women) with sufficient data to calculate all weight estimation methods. The Lorenz method performed best (P10 = 86.8%, P20 = 99.4%) and met the standard of acceptability across sex and body mass index subgroups. The Mercy and PAWPER XL-MAC methods performed acceptably in non-obese adults.ConclusionThe ideal weight estimation method should be accurate, rapid, simple, and feasible. This study has demonstrated the accuracy of 7 methods. The Lorenz method performed best but is complex and likely to be difficult to apply in resuscitation settings. Other simpler and quicker methods are at least as accurate as the best methods widely used in children, and there is potential for further calibrating these for use in adults before validation in real-world studies.© 2021 The Authors. JACEP Open published by Wiley Periodicals LLC on behalf of American College of Emergency Physicians.

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