Eur J Pediatr Surg 2020; 30(02): 205-209
DOI: 10.1055/s-0039-1681025
Original Article
Georg Thieme Verlag KG Stuttgart · New York

The Outcome of the Single Step Questionnaire in Pectus Excavatum Patients is Phase Dependent

Wietse P. Zuidema
1  Department of Surgery, Amsterdam UMC, Amsterdam, The Netherlands
2  Department of Pediatric Surgery, Amsterdam UMC, Amsterdam, The Netherlands
Alida F. W. van der Steeg
2  Department of Pediatric Surgery, Amsterdam UMC, Amsterdam, The Netherlands
3  Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, The Netherlands
Stefan van der Heide
4  Department of Cardiothoracic Surgery, Radboud University Nijmegen Medical Center, Radboud University Nijmegen, Nijmegen, The Netherlands
Gerda W. Zijp
5  Department of Pediatric Surgery, Juliana Children's Hospital, Hagaziekenhuis, The Hague, The Netherlands
Robertine van Baren
6  Department of Pediatric Surgery, University Medical Center Groningen, Groningen, The Netherlands
Jan W. A. Oosterhuis
7  Department of Thoracic Surgery, Medical Center Haaglanden, Den Hague, The Netherlands
Ernest van Heurn
2  Department of Pediatric Surgery, Amsterdam UMC, Amsterdam, The Netherlands
› Author Affiliations
Further Information

Publication History

13 July 2018

22 January 2019

Publication Date:
01 March 2019 (online)


Introduction Pectus excavatum (PE) is the most common chest wall deformity. Patients with PE may have cosmetic complaints, restricted physical capabilities, or both and may seek surgical correction. One method to assess satisfaction after surgery is the single step questionnaire (SSQ). Although the developers state that the SSQ produces a stabile score and only needs to be used once, we hypothesized that the score may depend on point in time after surgery.

Materials and Methods One hundred and eight patients from a longitudinal cohort of patients undergoing a Nuss bar placement for PE were selected. Mean age was 16.0 years (range: 12–29). SSQ was completed at 6 weeks, 6 months, 1 year, and 2 years postoperatively. Mean and median scores per question and total scores were calculated on each measurement moment. Overall scores were tested using the Friedman test.

Results There were significant differences in overall SSQ scores (p < 0.009) throughout the postoperative period, especially between 6 weeks and 6 months (p = 0.006). Scores on general health, exercise capacity, impact on social life, pain during hospital stay, and after discharge changed also significant in the first 2 years after Nuss bar placement.

Conclusion There were significant differences in total SSQ score depending on the time of application postoperatively. However, the most clinical relevant difference was between 6 weeks and 6 months. Assessment of the overall satisfaction postoperative with the SSQ questionnaire should not be done with a single measurement but rather at different postoperative time intervals before and after 6 months postoperatively.