A retrospective analysis of chest wall deformities incidentally detected in emergency department patients: an observational study

Abstract

Background:The most frequently observed chest wall deformities are pectus excavatum and pectus carinatum. The purpose of this observational study was to examine the prevalence of chest wall deformities in adult patients presenting for various reasons to the emergency department in our institution, a regional reference center for chest deformities, the demographic characteristics of patients with such malformations, emergency presentation symptoms, and the effects of deformities on patients' psychological state. Materials and Methods: Two hundred forty cases presented to the İzmir Katip Çelebi UniversityAtatürk Training and Research Hospital tertiary emergency department and meeting the inclusion criteria were investigated retrospectively. The cases' demographic data, presence of family histories of similar deformities, presenting symptoms, deformity depths, Haller indices, and patients' psychological deformity levels were determined and subjected to statistical analysis. Results:The prevalence of pectus excavatum among the patients presenting to our center was 1/308, while the prevalence of pectus carinatum was 1/698. The patients' mean age was 24.75 years, and 84.6% were men. The accompanying psychological deformity was present in only 28.33% of cases.The presence of family history was determined at 38.8%. The patients' mean Haller Index value was 3.16, and the mean depth of deformity was 2.5 cm. Haller Index values were significantly higher among patients with moderate or severe psychological deformity than in the other patients (p < 0.001). The Haller Index exhibited a high correlation with depth of deformity (p < 0.001) and a negative correlation with patients' body mass index values (p = 0.024). Conclusions:Chest wall deformities are a very common societal health problem, one that exhibits psychological effects and familial predisposition, and that can lead to various physiological problems.Familial disposition levels may vary among societies. Adult patients begin to tolerate the presence of low body mass index and psychological deformity. Prospective studies are now needed for greater clarification of these issues.