Model to estimate abdominal wall thickness in children undergoing placement or replacement of gastrostomy devices
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Read the article on jpedsurg.org ↗Article · Oct 2018 · 1 min read
In brief
In brief
This study developed age-stratified mathematical models to predict abdominal wall thickness in children requiring gastrostomy devices, using ultrasound measurements and body metrics including BMI and waist circumference. The models provide clinicians with a tool to estimate appropriate device length at initial placement and replacement, reducing complications from incorrect sizing.
Written by the GCMD Library team from the article.
Objectives
Abdominal wall thickness (AWT) is a key measurement when placing or replacing low profile gastrostomy devices. This measurement varies, depending on nutritional status and body habitus. We developed a mathematical model to estimate AWT using a compendium of body measurements.
Methods
Ultrasonography was used to measure AWT at the initial gastrostomy site in subjects aged 22 days to 24 years old. Other body measurements (height, weight, waist circumference and distance from xiphisternum to pubis) were also obtained. Multiple linear regression was used to develop two separate models using age of 2 years to separate the groups. For analysis, AWT is log transformed.
Results
Data from 97 subjects were used for analysis.
The final model for those ≤24 months old is the following:
ln(Estimated AWT) = −1.255 + 0.082*(1 if age 3–24 months, 0 if 24 months old is the following:
ln(Estimated AWT) = −1.335 + 0.271*(1 if age >84 months, 0 if 24–84 months) + 0.082*(BMI)
Conclusion
This model to estimate AWT is useful for determining the length of a gastrostomy device at initial placement and with subsequent changes. More data are needed to refine and further validate the model.
Level of evidence
Level IV, study of prognostic test.