Abstract
Objective
The Haller Index (HI), the standard metric for the severity of pectus excavatum, is
dependent on width and does not assess the depth of the defect. Therefore, we performed
a diagnostic analysis to assess the ability of HI to separate patients with pectus
excavatum from healthy controls compared to a novel index.
Methods
After institutional review board approval, computed tomography scans were evaluated
from patients who have undergone pectus excavatum repair and controls. The correction
index (CI) used the minimum distance between posterior sternum and anterior spine
and the maximum distance between anterior spine most anterior portion of the chest.
The difference between the two is divided by the latter (×100) to give the percentage
of chest depth the defect represents.
Results
There were 220 controls and 252 patients with pectus. Mean HI was 2.35, and the mean
CI was 0.92 for the controls. The mean HI was 4.06, and the mean CI was 31.75 in the
patients with pectus. In the patients with pectus, HI demonstrated a 47.8% overlap
with the controls, while there was no overlap for CI.
Conclusions
The Haller index demonstrates 48% overlap between normal patients and those with pectus
excavatum. However, the proposed correction index perfectly separates the normal and
diseased populations.
Key words
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References
- Use of CT scans in selection of patients for pectus excavatum surgery: A preliminary report.J Pediatr Surg. 1987; 22: 904-908
- Cardiorepiratory function is significantly improved following corrective surgery for severe pectus excavatum.J Cardiovasc Surg. 2000; 41: 125-130
- A 10-year review of a minimally invasive technique for the correction of pectus excavatum.J Pediatr Surg. 1998; 33: 545-552
- Use of a subxiphoid incision for pectus bar placement in the repair of pectus excavatum.J Pediatr Surg. 2010; 45: 1361-1364
- The predictive value of Haller Index in patients undergoing pectus bar repair for pectus excavatum.J Surg Res. 2011; 170: 104-106
Article info
Publication history
Accepted:
September 3,
2011
Received:
August 23,
2011
Footnotes
Presented at the Pacific Association of Pediatric Surgeons 44th Annual Meeting, Cancun, Mexico, April 10-14, 2011.
Identification
Copyright
© 2011 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
