Wednesday, October 3, 2018

Moving Beyond the #Haller Index as a Measure of #PectusExcavatum #Severity by Robert S Eisinger in BJSTR

Abstract

Due to increased awareness and recent advances in the minimally invasive repair of #PectusExcavatum (PE), a growing number of PE patients are considering corrective treatment. But patients and clinicians are faced with a pressing question: What are the indications for surgery? Due to the paucity of prospective PE studies, data-driven guidelines are currently lacking. The #Hallerindex (HI) has emerged as the predominant way to identify patients for which surgical treatment is most appropriate. Under this premise, patients with higher HI values – indicating a more severe chest deformity – are more likely to pursue and/or benefit from surgery. However, evidence is accumulating that HI may not accurately portray the underlying #physiologicdisruption or the symptoms associated with PE. In this Viewpoint, we discuss the origin of HI and describe its widespread use in practice today, despite its possible shortcomings, as well as alternative approaches for evaluating PE #severity.




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