CORRELATION BETWEEN DEFORMITY HEIGHT AND THE HALLER INDEX (HI) IN CHILDREN WITH PECTUS CARINATUM
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Abstract
Background: The Haller Index (HI) is commonly used as a morphologic measure of chest wall configuration; however, it relies on imaging, incurs cost, may be impractical for routine clinical follow-up. A simple anthropometric parameter such as external deformity height may serve as a useful surrogate if it demonstrates a strong relationship with HI.
Objective: To evaluate the correlation between deformity height and the Haller Index, and to provide clinical recommendations regarding its application in treatment monitoring treatment in children with pectus carinatum.
Methods: A cross-sectional study was conducted on 89 patients with Pectus carinatum treated at the Vietnam National Children's Hospital between May 2024 and May 2026.
Results: Deformity height showed a moderate inverse correlation with HI (r = - 0.425), which strengthened to a moderately strong inverse correlation after adjustment for age and sex (partial r = -0.6). The derived regression equation was: HI = 2.533 – 0.747*deformity height + 0.406*age – 0.101*sex. The model explained 37% of the variance in HI (R² = 0.37). Bland - Altman analysis demonstrated a mean bias of 0 with 95% limits of agreement ranging from – 0.21 to 0.21.
Conclusion and Recommendations: This parameter may be used as a clinical tool for screening or as an adjunct in assessing deformity severity and monitoring clinical progression in patients with Pectus carinatum.
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Keywords
pectus carinatum, Haller Index, deformity height, Bland–Altman, anthropometry
References
2. Alaca N. Pectus deformities: body image and quality of life. In: Martin CR, Preedy VR, Patel VB, Rajendram R, editors. Handbook of the behavior and psychology of disease. Cham: Springer; 2025:1559-75. https://doi.org/10.1007/978-3-031-73363-5_65
3. Haller JA Jr, Kramer SS, Lietman SA. Use of CT scans in selection of patients for pectus excavatum surgery: a preliminary report. J Pediatr Surg 1987;22(10):904-6. https://doi.org/10.1016/s0022-3468(87)80585-7
4. Robertson JO, Gigena C, DiFiore JW. Use of a novel maximum protrusion index to describe severe pectus carinatum. J Pediatr Surg 2026;61(2):162662. https://doi.org/10.1016/j.jpedsurg.2025.162662
5. National Cancer Institute. Radiation risks and pediatric computed tomography (CT): a guide for health care providers [Internet]. Bethesda (MD): National Cancer Institute; [cited 2026 Apr 27]. Available from: https://www.cancer.gov/about-cancer/causes-prevention/risk/radiation/pediatric-ct-scans
6. Frediani S, Zarfati A, Pardi V et al. A new custom-made bivalve brace for pectus carinatum in children and adolescents: preliminary promising experience of 140 patients from a tertiary center. Front Pediatr 2024;12:1321633. https://doi.org/10.3389/fped.2024.1321633
7. Omaník P, Kozlíková K, Daumová N et al. The role of anthropologic measurements in pectus carinatum brace treatment evaluation. Meas Sci Rev 2022;22(1):50-57. https://doi.org/10.2478/msr-2022-0006
8. Fraser S, Harling L, Patel AJ et al. External compressive bracing with initial reduction of pectus carinatum: compliance is the key. Ann Thorac Surg 2020;109(2):413-419. https://doi.org/10.1016/j.athoracsur.2019.08.026