Sarah Daaboul*, Amal Naous, Soha Ghanem and Mariam Rajab


Background: Failure to thrive (FTT) is a state of under nutrition due to inadequate caloric intake, inadequate caloric absorption, or excessive caloric expenditure. Prompt diagnosis and intervention are important for preventing malnutrition and developmental sequelae. Organic (medical) and nonorganic (social or environmental) often contribute to FTT. Objectives: The primary objective of this study was to determine the etiologies of FTT among children admitted to Makassed General Hospital. The secondary objective was to compare the anthropometric criteria between patients with organic and nonorganic causes. Methods: A retrospective chart review study was conducted at Makassed General Hospital, Beirut, Lebanon, a tertiary center, on children aged between 1 month and 13 years who were discharged with a diagnosis of FTT in the period between January 2007 and June 2017. We studied the etiologies of FTT and divided them into two groups: organic and nonorganic causes. Then we compared the two groups regarding the demographic data, and the different anthropometric criteria (weight < 5th percentile for age, height < 5th percentile for age, BMI < 5th percentile for age, Weight deceleration across > 2 major percentiles since birth, weight < 75 % of median weight for age). Results: A total of 356 children received the diagnosis of FTT, 90 (25.2%) were excluded from the study because they did not complete the workup. Organic causes were found in 57.3% of patients, while 17.4% had non organic causes. Organic causes were primarily related to the gastrointestinal tract 39.7%, followed by endocrine 22.5%, and immunodeficiency 9.3%, and others. The comparison of the anthropometric criteria between patients with organic and nonorganic FTT showed a statistical significance in weight < 5th percentile for age: organic (68.8%) vs nonorganic (53.2%) with P value 0.02, and in height < 5th percentile for age: organic (62%) vs nonorganic (45.2%) with P value 0.02. Conclusion: Organic causes of FTT were the most common, with gastrointestinal disorders being the leading cause. Patients with weight and height below the 5th percentile were more common among the organic causes group.

Keywords: Failure to thrive, organic, nonorganic, anthropometric criteria, hospitalization.

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