Mínguez Gómez A, Fonseca Martín R, Gutiérrez San Román C, Barrios Fontoba J E, Crehuet Gramatyka D, Miró Rubio I, Vila Carbó J J
Hospital Universitari i Politècnic La Fe. Valencia.
Cir Pediatr. 2019 Jan 21;32(1):2-5.
The Haller index (HI) is widely used to indicate surgical intervention in patients with pectus excavatum (PE). However, in patients with an atypical thoracic morphology, the severity of the defect can be incorrectly estimated. We propose comparing this index with the correction index (CI).
We analyzed clinical data and CT scans of 50 patients who consulted for PE in our center between 2010 and 2017. Haller index (HI), Correction index (CI) and ideal thoracic index (ITI) were calculated for each patient. The ITI allowed dividing the sample into two groups based on the thoracic morphology by excluding the PE component, therefore separating those with thorax too wide or too narrow from the standard patients. A standard group (36 patients) and a non-standard group (14 patients) were generated, among which the HI and the CI were correlated.
The mean HI and CI of all patients were 3.99 and 27%, respectively. 31 of the 50 patients (62%) underwent intervention, 8 of them with an HI below 3.25. When comparing both groups, there was a moderate correlation between HI and CI in the standard group (Spearman r 0.799, p <0.01) and a greater correlation in the non-standard group (Spearman r 0.858, p <0.01).ween the scale and the presence of foreign body, except for SCORE 1, which was 57% what we attribute to an information bias. If the foreign body were not nuts, inorganic or bone, its aspiration was very unlikely, that is why we included it in the SCORE with -1.
In our cohort, correlation of HI and CI was not different between both groups of patients. The CI did not prove its superiority when compared to HI in the surgical indication of patients with PE.
哈勒指数(HI)被广泛用于指示漏斗胸(PE)患者的手术干预。然而,在胸廓形态不典型的患者中,缺损的严重程度可能会被错误估计。我们建议将该指数与矫正指数(CI)进行比较。
我们分析了2010年至2017年间在我们中心因漏斗胸前来咨询的50例患者的临床数据和CT扫描结果。为每位患者计算哈勒指数(HI)、矫正指数(CI)和理想胸廓指数(ITI)。通过排除漏斗胸成分,ITI允许根据胸廓形态将样本分为两组,从而将胸廓过宽或过窄的患者与标准患者区分开来。生成了一个标准组(36例患者)和一个非标准组(14例患者),其中HI和CI进行了相关性分析。
所有患者的平均HI和CI分别为3.99和27%。50例患者中有31例(62%)接受了干预,其中8例HI低于3.25。比较两组时,标准组中HI和CI之间存在中度相关性(Spearman r 0.799,p<0.01),非标准组中相关性更强(Spearman r 0.858,p<0.01)。除了评分为1的情况外,量表与异物存在之间存在关联,我们将评分为1的情况归因于信息偏差,其发生率为57%。如果异物不是坚果、无机物或骨头,那么其被误吸的可能性非常小,这就是为什么我们将其以-1分纳入评分中的原因。
在我们的队列中,两组患者的HI和CI相关性无差异。在漏斗胸患者的手术指征方面,与HI相比,CI并未证明其优越性。