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Increasing age at time of pectus excavatum repair in children: emerging consensus?

Dominic Papandria1, Jamir Arlikar, Maria Grazia Sacco Casamassima

  • 1Center for Pediatric Surgical Clinical Trials & Outcomes Research, Division of Pediatric Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287-0005, USA.

Journal of Pediatric Surgery
|January 22, 2013
PubMed

Insights

The average age for pectus excavatum repair increased significantly between 1998 and 2009. This trend suggests a shift in surgical patient selection for pectus excavatum, potentially reflecting evolving treatment consensus.

Area of Science:

  • Pediatric Surgery
  • Thoracic Surgery
  • Medical Database Analysis

Background:

  • Surgical techniques for pectus excavatum repair are evolving.
  • Practice patterns in pectus excavatum repair are changing.
  • Understanding trends in operative age is crucial for surgical practice.

Purpose of the Study:

  • To examine trends in operative age for pectus excavatum repair.
  • To analyze age at operation using a nationwide administrative database.
  • To identify changes in patient selection over time.

Main Methods:

  • Cross-sectional descriptive analysis of Nationwide Inpatient Sample (NIS) and Kids' Inpatient Database (KID) data (1998-2009).
  • Selection of pediatric discharges for surgical repair of pectus excavatum.
  • Sub-grouping patients by age at operation and calendar year of repair.

Main Results:

  • A total of 5830 elective admissions were analyzed.
  • Mean age at operation increased from 11.8 to 14.4 years over the study period.
  • Patient age at repair was significantly higher in more recent years (P < .001).

Conclusions:

  • The age at operation for pectus excavatum repair has steadily increased.
  • Decreased variability in age at operation was observed.
  • This pattern may reflect an evolving consensus on optimal pectus excavatum management.
Abstract

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