Physician-Estimated Depth as a Screening Tool for Computed Tomography Evaluation of Pectus Excavatum
| Autor: | Adam C. Alder, Dave Schindel, Faisal Qureshi, Heather Postma, Ali Mokdad, Jillian Jacobson, Barry Hicks, Samir Pandya |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Sensitivity and Specificity Severity of Illness Index 03 medical and health sciences 0302 clinical medicine Pectus excavatum Reference Values Preoperative Care medicine Deformity Humans Mass Screening Thoracic Wall Retrospective Studies Anthropometry business.industry Patient Selection Incidence (epidemiology) Retrospective cohort study medicine.disease Funnel Chest 030220 oncology & carcinogenesis Pectus carinatum Female 030211 gastroenterology & hepatology Surgery Haller index Radiology Underweight medicine.symptom Tomography X-Ray Computed business Body mass index |
| Zdroj: | Journal of Surgical Research. 256:687-692 |
| ISSN: | 0022-4804 |
| DOI: | 10.1016/j.jss.2020.03.072 |
| Popis: | BACKGROUND Pectus excavatum (PE) is the most common congenital chest wall anomaly with a reported incidence of 1/300 to 1/400 live births and a male predominance. Preoperative evaluation of defect severity typically requires a calculation of the Haller index (HI) and/or correction index (CI) using computed tomography (CT) or x-rays. The purpose of this study was to determine whether physician-estimated depth (PED), a bedside screening tool, could be used to identify a subset of pediatric patients in whom CT was unnecessary. METHODS After institutional review board approval (IRB #032018-091), we retrospectively reviewed all patients with a diagnosis of PE between 2009 and 2018 at our academic pediatric center. Demographic information including age, sex, and body mass index were abstracted. Imaging was reviewed to obtain HI and CI and to retrospectively calculate PED. The PED is calculated at the bedside by measuring the depth of the pectus at the site of greatest depression relative to a horizontal surface laid across the deformity. For this retrospective study, we calculated the CT-derived PED by measuring the depth from the horizontal on the respective CT images. Patients without imaging studies and patients with pectus carinatum, arcuatum, or mixed deformities were excluded from this study. RESULTS A total of 94 patients met inclusion criteria. Of these, 82% were male, with a median age of 15 y. Patients were further subdivided by BMI, with 46% of patients having a BMI of |
| Databáze: | OpenAIRE |
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