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Improving Quality of Life With Dynamic Compression Bracing in Patients With Pectus Carinatum
Hendrik van Braak1, Sjoerd A de Beer2, Jos W R Twisk3
1Department of Pediatric Surgery, Emma Kinderziekenhuis Amsterdam University Medical Center, Meibergdreef 9, 1105AZ Amsterdam, the Netherlands; Department of Surgery, Leiden University Medical Center, Albinusdreef 2, 2333ZA Leiden, the Netherlands.
Background:
Patients with pectus carinatum have lower quality of life and self-esteem than their peers. We assessed the impact of dynamic compression system bracing on quality of life in patients with pectus carinatum.
Methods:
We conducted a prospective cohort study on patients aged 10-21 years. We assessed quality of life using the Child Health Questionnaire-87, the State-Trait Anxiety Inventory-6, the World Health Organization Quality of Life-BREF, the 36-Item Short Form Survey, and the Single-Step Questionnaire adapted for pectus carinatum.
Results:
Between March 2013 and March 2016, 225 patients treated with dynamic compression system bracing were included. Patients showed improvements across the overall scores of the 36-Item Short Form Survey (Δ7.7 (2.9-12.4)), Single-Step Questionnaire (Δ4.1 (2.0-6.3)) and three out of four World Health Organization Quality of Life-BREF domains (physical health (Δ8.7 (3.7-13.7)), psychological health (Δ11.8 (6.1-17.5)), environment (Δ5.7 (0.2-11.3))). No changes across the Child Health Questionnaire-87 overall score were observed (Δ5.5 (-0.5-11.5)). Most improvement occurred within six to twelve months after treatment initiation, stabilizing thereafter. Anxiety scores on the State-Trait Anxiety Inventory-6 did not improve (Δ0.5 (-0.1-1.2)). Scores on physical complaints, pain, psychological health and self-esteem/self-image improved across all questionnaires. In contrast to the successfully treated group, the unsuccessfully treated group showed no improvement on any of the questionnaires. Most patients (87.2 %) would choose bracing again, 94.9 % of patients were satisfied with the treatment.
Conclusions:
Dynamic compression system bracing improves quality of life, reduces physical complaints and pain and boosts psychological health and self-esteem in patients with pectus carinatum.
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