Prognostic Factors for Pectus Carinatum Treated by Dynamic Compression System: PECTUSDYN Trial.

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).