The traditional ‘APLS formula’ for weight estimation in children based on age (wt in kg = [age+4] x 2) is recognised as underestimating weight in ‘developed’ countries, with the degree of underestimation increasing with increasing age.
Several authors have attempted to derive a more accurate formula.
In the UK, the measured weights of over 93 000 children aged 1-16 who attended a paediatric emergency department were used to compare a previously derived formula (wt=3[age]+7) with the APLS formula.
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%); this latter formula remained applicable from 1 to 13 years inclusive.
The authors state: ‘The APLS formula has clearly become a victim of better nourished children. With a mean underestimate of more than 20% (nearly 40% at age 10 years), its place as a weight estimation tool is questionable…. To continue with an inaccurate formula with no evidence base cannot be considered good medical practice.’
Weight estimation in paediatrics: a comparison of the APLS formula and the formula ‘Weight=3(age)+7’
Emerg Med J. 2010 Jul 20. [Epub ahead of print]
A previous retrospective Australian study on over 70 000 paediatric ED attendances derived formulae for three different age ranges:
- For Infants < 12 months: Weight (kg) = (age in months + 9)/2
- For Children aged 1-5 years: Weight (kg) = 2 x (age in years + 5)
- For Children aged 5-14 years: Weight (kg) = 4 x age in years.
Make your Best Guess: An updated method for paediatric weight estimation in emergencies
Emerg Med Australas. 2007 Dec;19(6):528-34