European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2026
Prognostic Factors for Pectus Carinatum Treated by Dynamic Compression System: PECTUSDYN Trial.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Kieffer De Marco Lorraine, Filaire Laura, Vermersch Sophie, Chapelle Céline, Garcin Arnauld, Tiffet Olivier, Scalabre Aurélien
Аннотация
OBJECTIVES: Dynamic compression bracing (DCB) systems have been proven safe and effective for non-surgical treatment of pectus carinatum (PC). This study aimed to identify potential prognostic factors for correcting PC using DCB.
METHODS: From 2011 to 2020, all patients treated with DCB for PC at the University Hospital of Saint-Etienne were reviewed retrospectively. The primary outcome was a ≤50% reduction in pectus height (PH) at the 6-month follow-up, measured by radiation-free imaging. Two statistical models adjusted for compliance with treatment were used.
RESULTS: A total of 297 patients were treated with DCB (mean age: 15.4 ± 3.9 years). A total of 42% of deformities were symmetrical. Baseline mean PH and pressure for initial correction (PIC) were 2.97 ± 1.02 cm and 6.5 ± 2.0 psi, respectively. The median total treatment duration was 13.1 months (9.2-17.9). Among the 114 (46.5%) patients with available PH data, the median decrease in PH was -35.8% (-62.4% to -10.0%) after 6 months of DCB, with 61 patients (53.5%) achieving a reduction ≥ 50% in PH. In multivariate analysis, only PIC (odds ratio = 1.34; 95% confidence interval, 1.09-1.64; P = .005) was significantly associated with PH reduction in model 1, and PIC ≥ 7.5 psi (odds ratio = 2.53; 95% confidence interval, 1.13-5.67; P = .024) in model 2. Patient compliance was 85.2% at 6 months. The recurrence rate was 11.3% (n = 26).
CONCLUSIONS: The PIC value appears to be a potential prognostic factor for PH reduction after 6 months of treatment with DCB. These results will be validated in an ongoing prospective study.
CLINICAL TRIAL: The study was approved by the ethical committee "Terres d'Ethique" (IRBN902020/CHUSTE) and registered at Clinicaltrials.gov (NCT04452721).
METHODS: From 2011 to 2020, all patients treated with DCB for PC at the University Hospital of Saint-Etienne were reviewed retrospectively. The primary outcome was a ≤50% reduction in pectus height (PH) at the 6-month follow-up, measured by radiation-free imaging. Two statistical models adjusted for compliance with treatment were used.
RESULTS: A total of 297 patients were treated with DCB (mean age: 15.4 ± 3.9 years). A total of 42% of deformities were symmetrical. Baseline mean PH and pressure for initial correction (PIC) were 2.97 ± 1.02 cm and 6.5 ± 2.0 psi, respectively. The median total treatment duration was 13.1 months (9.2-17.9). Among the 114 (46.5%) patients with available PH data, the median decrease in PH was -35.8% (-62.4% to -10.0%) after 6 months of DCB, with 61 patients (53.5%) achieving a reduction ≥ 50% in PH. In multivariate analysis, only PIC (odds ratio = 1.34; 95% confidence interval, 1.09-1.64; P = .005) was significantly associated with PH reduction in model 1, and PIC ≥ 7.5 psi (odds ratio = 2.53; 95% confidence interval, 1.13-5.67; P = .024) in model 2. Patient compliance was 85.2% at 6 months. The recurrence rate was 11.3% (n = 26).
CONCLUSIONS: The PIC value appears to be a potential prognostic factor for PH reduction after 6 months of treatment with DCB. These results will be validated in an ongoing prospective study.
CLINICAL TRIAL: The study was approved by the ethical committee "Terres d'Ethique" (IRBN902020/CHUSTE) and registered at Clinicaltrials.gov (NCT04452721).