To the Editor.—In their article "Categorization of Etiology of Failure to Thrive" in the September issue (Journal 1981;135:848-851), Drs Homer and Ludwig nicely documented how careful attention to historic and physical examination data can trim the costs of unnecessary laboratory testing and "acute-care" hospitalization. However, I believe that their initial identification of the study population by admitting diagnosis may have underestimated and oversimplified their failure-to-thrive population.
We recently conducted a retrospective study of infants and children between 6 months and 6 years of age who were admitted to the inpatient service of a university hospital. The admission weights of 51 of the 330 patients were less than the fifth percentile. The low weights could not be accounted for by prior diagnoses. Twenty-nine of these patients (57% ) had associated developmental delays. Forty-one of these patients (80% ) had acute complaints. Only 16 patients (31%) were identified as having failure to thrive