Abstract
Introduction Pectus excavatum patients frequently experience psychosocial distress, yet the relationship
with morphological features of the deformity remains unexplored. We hypothesize that
certain morphological features analyzed by 3D optical surface imaging contribute more
prominently to the distress experienced by pectus excavatum patients as they impact
the visible severity of the deformity.
Materials and Methods Consecutive pectus excavatum patients who received three-dimensional optical surface
imaging between August 2019 and November 2022 were included. Logistic regression analysis
assessed the association between morphological features and psychosocial distress
in which the distress was scored as a binary variable, based on a self-reported assessment.
Results Among 215 patients, 55% reported psychosocial distress with multivariable analyses
revealing greater depth and length of the deformity being significantly correlated
with psychosocial distress. However, this prediction model demonstrated a moderate
discriminative ability with an area under the receiver operating characteristic curve
of 0.66 (95% confidence interval [CI], 0.59–0.73) for pectus depth and 0.58 (95% CI,
0.51–0.66) for pectus length.
Conclusions The morphological features of length and depth of the deformity are correlated with
psychosocial distress. Nonetheless, these individual features are weak predictors
due to their moderate discriminative ability. This underscores that other patient-related
factors, such as personality traits, neuropsychological conditions, and other psychosocial
influences, are likely to play a role in the occurrence of psychosocial distress.
Future studies should investigate these variables alongside the incorporation of standardized
instruments for measuring psychosocial distress to better understand and address the
distress in this population.
Keywords
pectus excavatum - 3D optical imaging - psychosocial functioning - morphological features
