Prevalence of pectus excavatum in an adult population-based cohort estimated from radiographic indices of chest wall shape.
Adolescent
Adult
Child
Cohort Studies
Female
Funnel Chest
/ diagnostic imaging
Humans
Male
Middle Aged
Prevalence
Radiography, Thoracic
/ methods
Ribs
/ abnormalities
Severity of Illness Index
Texas
/ epidemiology
Thoracic Wall
/ abnormalities
Tomography, X-Ray Computed
/ methods
Xiphoid Bone
/ abnormalities
Young Adult
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2020
2020
Historique:
received:
27
06
2019
accepted:
17
04
2020
entrez:
8
5
2020
pubmed:
8
5
2020
medline:
10
9
2020
Statut:
epublish
Résumé
Pectus excavatum is the most common chest wall skeletal deformity. Although commonly evaluated in adolescence, its prevalence in adults is unknown. Radiographic indices of chest wall shape were analyzed for participants of the first (n = 2687) and second (n = 1780) phases of the population-based Dallas Heart Study and compared to clinical cases of pectus (n = 297). Thoracic computed tomography imaging studies were examined to calculate the Haller index, a measure of thoracic axial shape, and the Correction index, which quantitates the posterior displacement of the sternum relative to the ribs. At the level of the superior xiphoid, 0.5%, 5% and 0.4% of adult Dallas Heart Study subjects have evidence of pectus excavatum using thresholds of Haller index >3.25, Correction index >10%, or both, respectively. Radiographic measures of pectus are more common in females than males and there is a greater prevalence of pectus in women than men. In the general population, the Haller and Correction indices are associated with height and weight, independent of age, gender, and ethnicity. Repeat imaging of a subset of subjects (n = 992) demonstrated decreases in the mean Haller and Correction indices over seven years, suggesting change to a more circular axial thorax, with less sternal depression, over time. To our knowledge, this is the first study estimating the prevalence of pectus in an unselected adult population. Despite the higher reported prevalence of pectus cases in adolescent boys, this study demonstrates a higher prevalence of radiographic indices of pectus in adult females.
Sections du résumé
BACKGROUND
Pectus excavatum is the most common chest wall skeletal deformity. Although commonly evaluated in adolescence, its prevalence in adults is unknown.
METHODS AND FINDINGS
Radiographic indices of chest wall shape were analyzed for participants of the first (n = 2687) and second (n = 1780) phases of the population-based Dallas Heart Study and compared to clinical cases of pectus (n = 297). Thoracic computed tomography imaging studies were examined to calculate the Haller index, a measure of thoracic axial shape, and the Correction index, which quantitates the posterior displacement of the sternum relative to the ribs. At the level of the superior xiphoid, 0.5%, 5% and 0.4% of adult Dallas Heart Study subjects have evidence of pectus excavatum using thresholds of Haller index >3.25, Correction index >10%, or both, respectively. Radiographic measures of pectus are more common in females than males and there is a greater prevalence of pectus in women than men. In the general population, the Haller and Correction indices are associated with height and weight, independent of age, gender, and ethnicity. Repeat imaging of a subset of subjects (n = 992) demonstrated decreases in the mean Haller and Correction indices over seven years, suggesting change to a more circular axial thorax, with less sternal depression, over time.
CONCLUSIONS
To our knowledge, this is the first study estimating the prevalence of pectus in an unselected adult population. Despite the higher reported prevalence of pectus cases in adolescent boys, this study demonstrates a higher prevalence of radiographic indices of pectus in adult females.
Identifiants
pubmed: 32379835
doi: 10.1371/journal.pone.0232575
pii: PONE-D-19-18160
pmc: PMC7205298
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0232575Subventions
Organisme : NCATS NIH HHS
ID : UL1 TR000451
Pays : United States
Organisme : NCATS NIH HHS
ID : KL2 TR000453
Pays : United States
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
J Pediatr Surg. 2011 Dec;46(12):2270-3
pubmed: 22152863
Int J Obes (Lond). 2007 Sep;31(9):1456-63
pubmed: 17593906
Ann Surg. 2010 Dec;252(6):1072-81
pubmed: 21107118
Ann Thorac Surg. 2014 Apr;97(4):1176-9; discussion 1179-80
pubmed: 24582050
AJR Am J Roentgenol. 2011 Nov;197(5):W934-9
pubmed: 22021545
Paediatr Respir Rev. 2003 Sep;4(3):237-42
pubmed: 12880759
Int J Obes (Lond). 2005 Dec;29(12):1478-83
pubmed: 16172620
Birth Defects Orig Artic Ser. 1975;11(10):1-22
pubmed: 130944
Ann Surg. 2000 Mar;231(3):443-8
pubmed: 10714639
Thorax. 1998 Jan;53(1):39-42
pubmed: 9577520
J Pediatr Surg. 1987 Oct;22(10):904-6
pubmed: 3681619
Arch Bronconeumol. 2013 May;49(5):196-200
pubmed: 23218256
J Bras Pneumol. 2009 Mar;35(3):221-6
pubmed: 19390719
J Pediatr Surg. 2013 Oct;48(10):2011-6
pubmed: 24094949
Semin Thorac Cardiovasc Surg. 2009 Spring;21(1):44-57
pubmed: 19632563
J Am Board Fam Med. 2010 Mar-Apr;23(2):230-9
pubmed: 20207934
Eur J Epidemiol. 1993 Jul;9(4):373-80
pubmed: 8243591
J Pediatr. 2011 Aug;159(2):256-61.e2
pubmed: 21429515
Iran J Pediatr. 2010 Jun;20(2):221-4
pubmed: 23056708
J Pediatr Surg. 2013 Jan;48(1):184-90
pubmed: 23331813
J Pediatr Surg. 2006 Sep;41(9):1573-81
pubmed: 16952594
Am J Cardiol. 2004 Jun 15;93(12):1473-80
pubmed: 15194016
Pediatr Radiol. 2004 Apr;34(4):326-30
pubmed: 14740200
Indian J Pediatr. 2010 Sep;77(9):1017-9
pubmed: 20814837
J Anat. 2016 Oct;229(4):577-81
pubmed: 27240848
Ann Thorac Surg. 2016 Dec;102(6):1886-1891
pubmed: 27526652
Eur J Cardiothorac Surg. 2016 Dec;50(6):1102-1109
pubmed: 27165768