Anthropometric approximation of body weight in unresponsive stroke patients

Background and purpose: Thrombolysis of acute ischemic stroke is strictly based on body weight in order to ensure efficacy and to prevent bleeding complications. Many candidate stroke patients are unable to communicate their body weight, and there is mostly neither the means nor the time to weigh the patient. Instead, it has to be visually estimated by the attending physician, but this is known to be inaccurate. Methods: Based on a large general population sample of nearly 7,000 subjects, we constructed approximation formulae for estimating body weight from simple anthropometric measurements (body height, waist and hip circumference). These formulae were validated in a sample of 178 consecutive in-patients admitted to our stroke unit, and their accuracy was compared with the best visual estimation of two experienced physicians. Results: The simplest formula gave the most accurate approximation (mean absolute difference 3.1±2.6kg), which was considerably better than the best visual estimation (physician 1: 6.5±5.2kg, physician 2: 7.4±5.7kg). It reduced the proportion of weight approximations mismatched by >10% from 31.5% and 40.4% (physicians 1 and 2 respectively) to 6.2% (anthropometric approximation). Only the patient′s own estimation was more accurate (mean absolute difference 2.7±2.4kg). Conclusions: By using an approximation formula based on simple anthropometric measurements (body height, waist and hip circumference), it is possible to obtain a quick and accurate approximation of body weight. In situations where the exact weight of unresponsive patients cannot be ascertained quickly, we recommend using this approximation method rather than visual estimation.