Response to Letter Regarding Article, “Estimating Weight of Patients With Acute Stroke When Dosing for Thrombolysis”
Thank you for your interest and letter in response to our research article.1 Having read your article, it is encouraging to note the concordance in results; after use of similar methodologies, both studies suggest that there may be a quantifiable effect on patient outcome as a result of weight estimation errors and subsequent misdosing of alteplase.2
Your observation that patients self-report on their weight more accurately is an interesting one and well recognized in the literature.3 As our study was principally designed to determine the performance of clinical staff in the estimation of weight, we did not ask patients for their own estimates. As many patients with stroke are dysphasic on arrival, we felt that clinical weight estimates represent a more commonly used scenario.
Indeed, as 11% of patients incorrectly reported their own weight in your study, it could be argued that this is unacceptably high and therefore an accurate weight measurement would be used. However, patients’ own estimates are undoubtedly preferable to the one made by clinical staff, as highlighted by your study.
Weight estimations for our study were performed by different healthcare professionals including doctors but mainly nurses.
We would reiterate that the estimation of patients’ weight by healthcare professionals is often inaccurate, potentially leading to poorer outcomes for acute ischemic stroke. A prospective study comparing accurately weighed patients with estimates may shed light on the exact functional outcome improvements to be gained by such a simple measure. Meanwhile, we would strongly argue that at least one automated weighing bed be mandated to be available in every acute setting.
Tom Barrow, BSc
Department of Medicine
University of Oxford
Oxford, United Kingdom
Pankaj Sharma, MD, PhD
Institute of Cardiovascular Research
Royal Holloway University of London (ICR2UL)
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- © 2016 American Heart Association, Inc.
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