Categorization of etiology of failure to thrive
C. Homer and S. Ludwig
To develop predictors of organic vs nonorganic causes of failure to thrive,
we performed a retrospective chart analysis of 82 hospitalized children. We
evaluated predictors by using decision analysis. We estimated potential
cost reduction that would have resulted from early categorization of these
patients. Twenty-one cases had organic causes, 34 had nonorganic causes,
and 19 had both organic and nonorganic causes. Physical examination proved
to be a sensitive indicator of an organic component. The composite
psychosocial and clinical history, together with the physical examination,
accurately predicted the final category. The use of laboratory tests was
primarily for confirmation. The use of these factors to identify purely
nonorganic growth failure and an evaluation of such cases in an
intermediate care facility could save almost $8-- per patient. In-depth
psychosocial evaluation is important in all cases of failure to thrive.
