Determination of Body Surface Area and Formulas to Estimate Body Surface Area Using the Alginate Method

The purpose of this study was to determine the body surface area (BSA) based on the alginate method, to derive formulae for estimating BSA, and to compare the error of the present formula to previous formulas obtained from other countries. We directly measured the entire body surface area of 34 males (20-60 years old, 158.5-187.5 cm in height, 48.5-103.1 kg in body weight) and 31 females (20-63 years old, 140.6-173.1 cm, 36.8-106.1 kg) using alginate. The measurements showed that the BSA had a mean of 18,339 cm(2) (15,416-22,753 cm(2)) for males, and 16,452 cm(2) (12,825-22,025 cm(2)) for females. Based on these measurements, a regression model to estimate BSA was derived: Estimated BSA (cm(2))=73.31 Height (cm)(0.725) x Weight (kg)(0.425) (r(2)=0.999). The mean error of the formula was -0.1%, and did not show any significant difference by gender or body shape. When applied to the datasets (n=506) composed of various races (Caucasians, Africans, and Asians), the mean error of the formula was 0.4% and was smaller than that of DuBois & DuBois's, Gehan & George's, and Mosteller's formulas when applied to the same datasets. The errors of the three previous formulas were also within 2%. Overall, formulas based on the DuBois exponent (Weight(0.425) Height (0.725)) did not show any tendency of overestimation or underestimation by body shape, but other BSA-formulae showed differences by body shape. The present BSA formula has shown good accuracy in Korean adults of all weight categories compared to traditional formulas.