Accurate height and length estimation in hospitalized children not fulfilling WHO criteria for standard measurement: a multicenter prospective study

Lyvonne N Tume, Frederic V. Valla, Corrine Jotterand Chaparro, Claire Morice, Shancy Rooze, Carole Ford-Chessel, Julien BERTHILLER, Isabelle HARAN, Cristelle BOURGEAUD, Michael Tsapis, Bénédicte Gaillard-Le Roux, Evelyne GAUVARD, Claire LOIRE, Camille GUILLOT, Karine MOUNEYDIER, Paul NOLENT,, Thibault BLACHE, Fleur Cour-Andlauer, Fabien SUBTIL, Margaux HUOT

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Abstract

Purpose: In hospitalized children, height should be measured. When world health organization (WHO) height measurement gold standards is impossible, the ideal height estimation technique is still unclear.
Methods: We conducted an international prospective study in 8 different pediatric intensive care units to assess the accuracy, precision, practicability, safety, and inter-rater reliability of 12 different height estimation techniques, based on body segment measurement extrapolation, or other calculations using previous or projected heights. All extrapolation techniques were performed on each child, and later compared to their WHO gold standard heights.
Results: 476 patients were enrolled. In the <2-year subgroup, board length use and growth chart extrapolation performed best. In the ≥2-year subgroup, growth chart extrapolation and parents’ report were the most accurate, followed by height measurement alongside the body with a tape measure. In both groups, body segment extrapolations were poorly predictive and showed mean bias and limits of agreement that varied a lot with age. Most body segment-based techniques presented with frequent measurement difficulties, but children’s safety was rarely compromised. The inter-rater reliability of body segment measurement was low in the <2-year subgroup.
Conclusions: To accurately estimate height in hospitalized children, health care professionals should integrate the accuracy, precision, practicability, and reliability of each measurement technique to select the most appropriate one. Body segment-based techniques were the least accurate and should probably not be used. Simple techniques like growth chart extrapolation, or measurement alongside the body (and length board measurement in the youngest) should be implemented in daily practice.



Original languageEnglish
Pages (from-to)4275–4286
Number of pages12
JournalEuropean Journal of Pediatrics
Volume183
Early online date25 Jul 2024
DOIs
Publication statusE-pub ahead of print - 25 Jul 2024

Keywords

  • Pediatrics
  • anthropometry
  • critical care
  • nutritional status

Research Institutes

  • Health Research Institute

Research Centres

  • International Centre for Applied Research with childrEn, young people, pregnant women and families

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