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J Pediatr. 2011 Aug;159(2):256-61.e2. doi: 10.1016/j.jpeds.2011.01.065. Epub 2011 Mar 22.

Increasing severity of pectus excavatum is associated with reduced pulmonary function.

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1
Department of Mathematics and Statistics, Kennesaw State University, Kennesaw, GA, USA.

Erratum in

  • J Pediatr. 2012 Jan;160(1):181.

Abstract

OBJECTIVE:

To determine whether pulmonary function decreases as a function of severity of pectus excavatum, and whether reduced function is restrictive or obstructive in nature in a large multicenter study.

STUDY DESIGN:

We evaluated preoperative spirometry data in 310 patients and lung volumes in 218 patients aged 6 to 21 years at 11 North American centers. We modeled the impact of the severity of deformity (based on the Haller index) on pulmonary function.

RESULTS:

The percentages of patients with abnormal forced vital capacity (FVC), forced expiratory volume in 1 second (FEV(1)), forced expiratory flow from 25% exhalation to 75% exhalation, and total lung capacity findings increased with increasing Haller index score. Less than 2% of patients demonstrated an obstructive pattern (FEV(1)/FVC <67%), and 14.5% demonstrated a restrictive pattern (FVC and FEV(1) <80% predicted; FEV(1)/FVC >80%). Patients with a Haller index of 7 are >4 times more likely to have an FVC of ≤80% than those with a Haller index of 4, and are also 4 times more likely to exhibit a restrictive pulmonary pattern.

CONCLUSIONS:

Among patients presenting for surgical repair of pectus excavatum, those with more severe deformities have a much higher likelihood of decreased pulmonary function with a restrictive pulmonary pattern.

PMID:
21429515
DOI:
10.1016/j.jpeds.2011.01.065
[Indexed for MEDLINE]
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