Evaluation of quality of life and respiratory function in patients with pectus excavatum

Abstract

Introduction: Pectus Excavatum (PE), the most common of all congenital chest wall deformities, leads to psychosocial repercussions and seems to disturb quality of life. The impact on the cardio respiratory function and exercise abilities is debated. The aim of this study was to describe health related quality of life (HRQOL) and respiratory functions. Methods: This study involved PE patients with a project of cosmetic surgical repair by silicone implants. We evaluated pulmonary function tests (PFTs), cardio pulmonary exercise tests (CPET), HRQOL with the SF36 regarding the morphology characteristics of the deformity (CHIN classification , HALLER index, implant size). Results: 45 patients were included, the mean age was 30 years old with a 2.2 sex ratio. Only one patient (3%) described symptoms. PFTs revealed 2 obstructive syndromes and no restrictive syndrome (mean TLC: 97+/-11%). The mean peak VO2 was 85+/-13% of predicted (33+/-7 mL/min/kg). It was under 84% of the predicted value in 47% of patients (n=21), most of them were limited from deconditioning. None had cardiological, respiratory nor ventilatory limitations. Regarding HRQOL, the mean Physical Composite Score (PCS) was 88+/-10.6% and the mean Mental Composite Score (MCS) was 75.1+/-18.6%. In the patients under 24 years old, and in women with HALLER index over 5, MCS was lower (respectively 61,9% and 68.5%) than in the general population (76,27%). Conclusion: Patients had neither symptoms nor respiratory impairments, but some had a physical limitation due to deconditioning that did not impact their global quality of life. However, the younger patients and women with high HALLER index had an altered HRQOL due to psychosocial repercussions.