PREDICTING RESTING ENERGY-EXPENDITURE IN PATIENTS WITH MUSCULOSKELETAL DEFORMITIES

The aim of this study was to assess the validity of the commonly used equations (Harris-Benedict (HB), Schofield (S) and equations based on midarm circumference (MAC) and midarm muscle circumference (MAMC) in p redicting resting energy expenditure (REE) in a population of patients with musculoskeletal deformities. 20 kyphoscoliotic patients (15 fema le (F); 5 male (M); mean age 59.6 years) and 10 controls (7 F; 3M; 59. 8 years) were studied. REE measured by indirect calorimetry (IC) with a ventilated canopy system (Deltatrac metabolic monitor) was not signi ficantly different between patients and controls (Mean (SD) REE (MJ/24 h): Patients: 5.48 (1.1); controls: 5.28(0.8)). In patients with defo rmities the Schofield equation gave values which were closest to measu red REE (mean difference and limits of agreement IC vs S: 0.098 MJ/24 h; -0.822 and 1.018). The Harris-Benedict equation using height (Ht) a nd armspan (AS) in lieu of height also gave acceptable results (IC vs HB (Ht): 0.34; -0.638 and 1.318; IC vs HB (AS): 0.255; -0.683 and 1.25 3). Equations based on MAC and MAMC compared poorly (IC vs MAC equatio n: 0.398; -1.530 and 2.326; IC vs MAMC equation 0.687; -0.911 and 2.28 5). On regression analysis the equation REE = 0.295 (MAMC) + 0.0483 (A S) -0.0324 (age) -6.25 predicted REE best in the patient population (r (2) = 0.861).