Increasing severity of pectus excavatum is associated with reduced pulmonary function

J Pediatr. 2011 Aug;159(2):256-61.e2. doi: 10.1016/j.jpeds.2011.01.065. Epub 2011 Mar 22.


Objective: To determine whether pulmonary function decreases as a function of severity of pectus excavatum, and whether reduced function is restrictive or obstructive in nature in a large multicenter study.

Study design: We evaluated preoperative spirometry data in 310 patients and lung volumes in 218 patients aged 6 to 21 years at 11 North American centers. We modeled the impact of the severity of deformity (based on the Haller index) on pulmonary function.

Results: The percentages of patients with abnormal forced vital capacity (FVC), forced expiratory volume in 1 second (FEV(1)), forced expiratory flow from 25% exhalation to 75% exhalation, and total lung capacity findings increased with increasing Haller index score. Less than 2% of patients demonstrated an obstructive pattern (FEV(1)/FVC <67%), and 14.5% demonstrated a restrictive pattern (FVC and FEV(1) <80% predicted; FEV(1)/FVC >80%). Patients with a Haller index of 7 are >4 times more likely to have an FVC of ≤80% than those with a Haller index of 4, and are also 4 times more likely to exhibit a restrictive pulmonary pattern.

Conclusions: Among patients presenting for surgical repair of pectus excavatum, those with more severe deformities have a much higher likelihood of decreased pulmonary function with a restrictive pulmonary pattern.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Forced Expiratory Flow Rates / physiology*
  • Funnel Chest / complications
  • Funnel Chest / diagnosis*
  • Funnel Chest / physiopathology
  • Humans
  • Male
  • Prognosis
  • Prospective Studies
  • Radiography, Thoracic
  • Respiratory Insufficiency / diagnosis
  • Respiratory Insufficiency / etiology*
  • Respiratory Insufficiency / physiopathology
  • Severity of Illness Index
  • Spirometry
  • Tomography, X-Ray Computed
  • Vital Capacity / physiology*
  • Young Adult