Success and duration of dynamic bracing for pectus carinatum: A four-year prospective study

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• 作者：Sherif Emil^a ; ^b ; ^{Sherif.Emil@McGill.ca} ; Marika S&eacute ; vigny^a ; ^b ; Kathleen Montpetit^b ; Robert Baird^a ; ^b ; Jean-Martin Laberge^a ; ^b ; Jade Goyette^b ; Ian Finlay^b ; Guylaine Courchesne^b
• 关键词：Pectus carinatum ; Dynamic ; Bracing ; Outcomes ; Pressure
• 刊名：Journal of Pediatric Surgery
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：52
• 期：1
• 页码：124-129
• 全文大小：512 K
• 卷排序：52

文摘

This study sought to establish factors that can prognosticate outcomes of bracing for pectus carinatum (PC).MethodsProspective data were collected on all patients enrolled in a dynamic bracing protocol from July 2011 to July 2015. Pressure of correction (POC) was measured at initiation of treatment, and pressure of treatment (POT) was measured pre- and post-adjustment at every follow-up visit. Univariate and Cox regression analysis tested the following possible determinants of success and bracing duration: age, sex, symmetry, POC, and POT drop during the first two follow-up visits.ResultsOf 114 patients, 64 (56%) succeeded, 33 (29%) were still in active bracing, and 17 (15%) failed or were lost to follow-up. In successful patients, active and maintenance bracing was 5.66 ± 3.81 and 8.80 ± 3.94 months, respectively. Asymmetry and older age were significantly associated with failure. Multivariable Cox proportional hazard analysis of time-to-maintenance showed that asymmetry (p = 0.01) and smaller first drop in POT (p = 0.02) were associated with longer time to reach maintenance.ConclusionsPressure of correction does not predict failure of bracing, but older age, asymmetry, and smaller first drop in pressure of treatment are associated with failure and longer bracing duration.Level of evidenceProspective Study/Level of Evidence IV.