Height measurement in the critically ill patient: A tall order in the critical care unit

Ramesh Venkataraman, Lakshmi Ranganathan, Vipin Nirmal, J Kameshwaran, C V Sheela, M V Renuka, Nagarajan Ramakrishnan, Ramesh Venkataraman, Lakshmi Ranganathan, Vipin Nirmal, J Kameshwaran, C V Sheela, M V Renuka, Nagarajan Ramakrishnan

Abstract

Height measurement in the critical care unit is necessary for estimating ideal body weight and providing titrated patient care. In this study, we compare three methods of height assessment and evaluate their level of correlation and inter-observer reproducibility. Heights of 100 consecutive patients were assessed independently by two nurses by supine, four point, and arm span methods. Paired sample t-test, one-way analysis of variance, Tukey's honestly significant difference post-hoc analysis and Bland-Altman plots were performed to assess agreement between measurements. Arm span method showed higher mean height compared to supine and four point methods. Mean heights derived by supine and four point measurements were similar to each other but were significantly different from that of arm span method (P < 0.001). Inter-observer correlation of the measured heights was very good among all three methods. The supine method seems to be easy, accurate, and reproducible in our study.

Keywords: Arm span measurement; critically ill patients; four point measurement; height; height measurement; supine measurement.

Figures

Figure 1
Figure 1
Box plot of height measurements using the three different methods used in the critical care unit. The arm span method shows higher mean height compared to the other two methods
Figure 2
Figure 2
Bland–Altman curve to assess mean difference and limits of agreement. The mean difference between the two measurements is −1.655, and the limits of agreement are between −4.496 and 1.186, thus indicating a fairly good agreement

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