Epidemiology, presentation and aspirations in Pectus carinatum: a retrospective cohort study
Abstract
PURPOSE: To describe the epidemiology and clinical presentation of children with pectus carinatum; and the outcome of their first hospital clinic appointment.
METHODS: A single surgeon, retrospective cohort study of children presenting between 1998 and 2022. Demographic and clinical data were collected from the medical record.
RESULTS: We present 430 children with pectus carinatum; 364 boys and 66 girls. Their asymmetry was identified at a median age of 11 years (range 0-16 years). Girls developed carinae earlier than boys (10 vs 14 years, p = 0.003), were more likely to present with pain (44% vs 26%, p = 0.041) and were more likely to have a family history of chest wall deformity (33% vs 20%, p = 0.070). The majority (342, 69%) had an asymmetrical, isolated carinatum. Isolated carinae were mainly right dominant (174, 57%), conversely, mixed carinatum/ excavatum were typically left side dominant (10/15 vs 2/15, p = 0.008).
CONCLUSION: The clinical presentation of carinatum is heterogenous with apparent differences between males and females. A detailed history and examination are required; if clinicians record, in detail, the clinical context and morphology of the carinatum, a comparison of phenotype and outcome would become feasible. Simply stating "Carinatum" is not enough.
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 430 participants or records.
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