%0 Journal Article
%T "When to Nuss? patient age as a risk factor for complications of minimally invasive repair of pectus excavatum: a systematic review and meta-analysis".
%A Coughlin AC
%A Ahsanuddin S
%A Inglesby D
%A Fox C
%A Xu H
%A Margulies I
%A Sayegh F
%A Soudant C
%A Sacks HS
%A Kaufman A
%A Taub PJ
%J Pediatr Surg Int
%V 38
%N 3
%D Mar 2022
%M 35006367
%F 2.003
%R 10.1007/s00383-021-05049-z
%X <B>OBJECTIVE: </B>The optimal age for minimally invasive repair of pectus excavatum (MIRPE) is unclear; this study investigates the differences in complication rates among different age groups undergoing repair.<BR><B>METHODS: </B>PubMed and Embase databases were searched from inception to October 2020. To assess age as a risk factor for complications, odds ratios from relevant studies were analyzed using the Mantel-Haenszel method with a random-effects model for younger vs older patients. Specific complication rates were compared between the two cohorts using a chi-squared test.<BR><B>RESULTS: </B>Of the 4448 studies retrieved, 25 studies stratified complication data by age groups. From these studies, ten studies compared groups at ages < 18 and ≥ 18 and four studies compared ages < 20 and ≥ 20, and one study compared ages < 19 and ≥ 19. These fifteen studies reported on 5978 patients, with 1188 complications, for a complication rate of 19.87%. Older patients were more likely to have complications in a pooled analysis of studies comparing older vs younger patients (OR = 1.66, 95% CI = 1.28-2.14, heterogeneity I2 = 49%). Specifically, older patients were significantly more likely to experience pneumothorax, pleural effusion, wound infection, bar displacement, and reoperations.<BR><B>CONCLUSIONS: </B>Increased age is a risk factor for complications of MIRPE. This supports repair of pectus excavatum prior to late adolescence.