Literature DB >> 27278391

The impact of developing a pectus center for chest wall deformities.

Katherine W Gonzalez1, Brian G A Dalton1, Ashwini S Poola1, E Marty Knott1, Brendan Kurtz1, Charles L Snyder1, Shawn D St Peter1, George W Holcomb2.   

Abstract

PURPOSE: In 2011, we established a dedicated center for patients with chest wall deformities. Here, we evaluate the center's effect on patient volume and management.
METHODS: A retrospective review of 699 patients with chest wall anomalies was performed. Patients were compared, based on the date of initial consultation, before the pectus center opened (July 2009-June 2011, Group 1) versus after (July 2011-June 2013, Group 2). Analysis was performed utilizing Chi-square and Mann-Whitney U tests.
RESULTS: 320 patients were in Group 1 and 379 in Group 2, an 18.4 % increase in patient volume. Excavatum patients increased from 172 (Group 1) to 189 (Group 2). Carinatum patients increased from 125 (Group 1) to 165 (Group 2). Patients undergoing operative repair of carinatum/mixed defects dropped significantly from 15 % (Group 1) to 1 % (Group 2) (p < 0.01), whereas those undergoing nonoperative bracing for carinatum/mixed defects rose significantly from 19 % (Group 1) to 63 % (Group 2) (p < 0.01). Patients traveled 3-1249 miles for a single visit.
CONCLUSION: Initiating a dedicated pectus center increased patient volume and provided an effective transition to nonoperative bracing for carinatum patients. The concentrated focus of medical staff dedicated to chest wall deformities has allowed us to treat patients on a local and regional level.

Entities:  

Keywords:  Bracing; Chest wall anomaly; Pectus

Mesh:

Year:  2016        PMID: 27278391     DOI: 10.1007/s00383-016-3904-3

Source DB:  PubMed          Journal:  Pediatr Surg Int        ISSN: 0179-0358            Impact factor:   1.827


  14 in total

Review 1.  Is volume related to outcome in health care? A systematic review and methodologic critique of the literature.

Authors:  Ethan A Halm; Clara Lee; Mark R Chassin
Journal:  Ann Intern Med       Date:  2002-09-17       Impact factor: 25.391

2.  A novel measure for pectus excavatum: the correction index.

Authors:  Shawn D St Peter; David Juang; Carissa L Garey; Carey A Laituri; Daniel J Ostlie; Ronald J Sharp; Charles L Snyder
Journal:  J Pediatr Surg       Date:  2011-12       Impact factor: 2.545

Review 3.  Review of the technical variants in the repair of pectus excavatum.

Authors:  C A Laituri; C L Garey; S D St Peter
Journal:  Eur J Pediatr Surg       Date:  2010-06-07       Impact factor: 2.191

4.  Nonoperative management of pectus carinatum.

Authors:  Ala Stanford Frey; Victor F Garcia; Rebeccah L Brown; Thomas H Inge; Frederick C Ryckman; Aliza P Cohen; Greg Durrett; Richard G Azizkhan
Journal:  J Pediatr Surg       Date:  2006-01       Impact factor: 2.545

5.  Driving quality, value, and cost through men's health centers of excellence.

Authors:  Demetrius J Porche
Journal:  Am J Mens Health       Date:  2015-01

6.  Experience with a simple technique for pectus bar removal.

Authors:  Frankie B Fike; Vincent E Mortellaro; Corey W Iqbal; Susan W Sharp; Daniel J Ostlie; George W Holcomb; Ronald J Sharp; Charles L Snyder; Shawn D St Peter
Journal:  J Pediatr Surg       Date:  2012-03       Impact factor: 2.545

7.  Orthopedic specialty hospitals: centers of excellence or greed machines?

Authors:  Neil Badlani; Scott Boden; Frank Phillips
Journal:  Orthopedics       Date:  2012-03-07       Impact factor: 1.390

8.  Minimally invasive repair of pectus excavatum: a single institution's experience.

Authors:  K A Miller; R K Woods; R J Sharp; G K Gittes; K Wade; K W Ashcraft; C L Snyder; W M Andrews; J P Murphy; G W Holcomb
Journal:  Surgery       Date:  2001-10       Impact factor: 3.982

9.  Dynamic compression system for the correction of pectus carinatum.

Authors:  Marcelo Martinez-Ferro; Carlos Fraire; Silvia Bernard
Journal:  Semin Pediatr Surg       Date:  2008-08       Impact factor: 2.754

10.  Bracing is an effective therapy for pectus carinatum: interim results.

Authors:  Richy T Lee; Scott Moorman; Marc Schneider; David L Sigalet
Journal:  J Pediatr Surg       Date:  2013-01       Impact factor: 2.545

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