We read the article by Herrmann et al1 and were disappointed at the exclusion of patients with the acquired immunodeficiency syndrome from their study. Although much has been published on the diagnosis and management of this condition, surprisingly little attention has been paid to the importance of nutritional status and its parameters in this "wasting syndrome."
In our own study of 136 consecutive hospitalized patients with acquired immunodeficiency syndrome (unpublished data), we also identified the prognostic importance of a simple serum albumin measurement. The serum albumin level, determined at the time of hospital admission, proved to be an excellent predictor of hospital outcome, both in terms of survival and duration of hospital stay. The respective hospital mortalities for admission albumin levels of 35 g/L or greater, 30 to 35 g/L, 25 to 29 g/L, and less than 25 g/L were 3%, 20%, 40%, and 69%, respectively (P <.05). Similarly,