Development of a Clinical Predictive Score for Bracing Outcomes in Children with Pectus Carinatum: A Single-center Retrospective Study

作者：Haonan Wang, Yunyu He, Minhua Lin, Jiachi Liao, Le Li, Jiahang Zeng, Qinglin Yang, Zefeng Lin, Jianhua Liang · 发表于：European Journal of Pediatric Surgery · 年份：2026 · DOI：10.1055/a-2782-7127 · 研究领域：Pectus Deformity Diagnosis and Treatment、Scoliosis diagnosis and treatment、Automotive and Human Injury Biomechanics

Abstract Pectus carinatum (PC) is a common chest wall deformity, but there is currently a lack of predictive models and tools for forecasting deformity improvement with compressive orthotic bracing (COB) therapy. This study aimed to identify key factors influencing treatment outcomes, and to develop and integrate a predictive efficacy scoring tool with a clinical decision pathway to provide evidence-based treatment recommendations for pediatric PC patients. In this retrospective study, 182 pediatric PC patients evaluated and followed using three-dimensional scanning were enrolled. A multiple linear regression model was developed to create and validate a predictive efficacy scoring tool, which subsequently informed the establishment of a treatment decision pathway. The predictive model identified smaller initial external thoracic width (p < 0.001, β = − 0.644), older age at treatment initiation (p = 0.04, β = 0.271), good compliance (p = 0.008, β = 0.188), and favorable chest wall morphology (p = 0.033, β = 0.152) as independent predictors of deformity improvement. The model was optimized into a predictive efficacy scoring tool (Score = Expected %dEHI + 4.761). Comparison between the good response (score > 0) and poor response (score ≤ 0) groups confirmed the tool's excellent discriminative ability (8.348 vs. 15.320, p < 0.001). Treatment recommendations were derived by integrating the scoring tool with the decision pathway: children with score > 0 are strongly rec...