title: A prospective study on quality of life in youths after pectus excavatum correction.
abstract: BACKGROUND
  The impact of correction of pectus excavatum (PE) on adolescents' health-related quality of life (HRQL) has only been investigated in prospective designs using disease-specific measures and without controls. The aim of this prospective study was to evaluate the HRQL before and after surgical correction of PE using a generic HRQL measure, and to compare the reported level of HRQL before surgery with an age-comparable control group.
  
  
  METHODS
  Patients (n=107) and one of their parents (n=106) completed the generic HRQL measure: the Child Health Questionnaire before, 3 months, and 6 months after correction for PE. A control group (n=183) consisting of school children comparable in age completed the same measure on one occasion.
  
  
  RESULTS
  The patients' level of HRQL before surgery was comparable to the level of the controls except for physical functioning; here boys reported impaired function compared to controls (P<0.0001, d=0.72). Both patients and parents reported improved emotional wellbeing and self-esteem, as well as an increase in physical and social activities from pre- to post-surgery. These improvements were statistically significant (P≤0.001-0.03) and yielded moderate to high effect sizes (ƞ2=0.04-0.22).
  
  
  CONCLUSIONS
  The improvement of physical and psychosocial HRQL reported by both patients and their parents as proxy indicates the psychological implications of the deformity. Patients reported impaired physical function compared to controls. Further, pre-surgery differences in HRQL between the patients and the controls were lacking. However, the improvement in the patients' HRQL following surgery may justify the correction of pectus excavatum. The effect of the deformity on patients wellbeing compared with controls' needs to be addressed in further studies.
authors.affiliation: Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark.
authors.forename: Johanne Jeppesen
authors.initials: JJ
authors.lastname: Lomholt
authors.affiliation: Diploma in Health Science Program and Bachelor of Science in Nursing Program, Denmark.
authors.forename: Elisabeth Brammer
authors.initials: EB
authors.lastname: Jacobsen
authors.affiliation: Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark.
authors.forename: Mikael
authors.initials: M
authors.lastname: Thastum
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark;; Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark.
authors.forename: Hans
authors.initials: H
authors.lastname: Pilegaard
keywords: Nuss procedure; Pectus excavatum; health-related quality of life; prospective design; youths