Clinical and paraclinical characteristics of patients with pectus excavatum admitted for surgical treatment at a tertiary hospital in Vietnam

Background Pectus excavatum is the most common congenital chest wall deformity. This study aimed to describe the clinical and paraclinical characteristics of patients with pectus excavatum undergoing surgical treatment at a tertiary hospital in Vietnam. Methods This retrospective descriptive study reviewed medical records of patients with congenital pectus excavatum who underwent surgical treatment between November 2022 and November 2024. Of 239 records screened, 207 met the eligibility criteria and were included. Demographic characteristics, age at deformity recognition, age-appropriate body mass index classification, documented patient-reported symptoms and psychological concerns, Haller index, chest radiography, electrocardiography, echocardiography, and chest wall morphology were analyzed. Paired radiographic and computed tomography (CT) Haller measurements were compared using paired and agreement analyses. Results The mean age at surgery was 19.1 ± 5.9 years, and 178 patients (86.0%) were male. Most patients were reported to have been recognized immediately after birth (80.7%). Overall, 126 patients (60.9%) were classified as thin or underweight using age-appropriate criteria. Reduced exercise tolerance was documented in 59.9% of patients, psychological impact in 37.7%, exertional dyspnea in 17.4%, and chest pain in 6.3%. The mean Haller index was 3.66±0.94 on chest radiography and 3.83±0.92 on CT, with a mean paired difference of 0.18 (95% CI, 0.16–0.20; p < 0.001). Exact agreement in severity classification was 81.2%, with a quadratic-weighted kappa of 0.88. Echocardiography was normal in 95.6% of patients, and type 1B was the most frequent Park morphology (35.3%). Conclusions This study describes a selected cohort of surgically treated patients with pectus excavatum at a single tertiary center. Patients were predominantly male, more than half were adults, and thinness or underweight, reduced exercise tolerance, and documented psychological concerns were common. Radiographic and CT-based Haller severity classifications showed good agreement, although CT tended to yield slightly higher values. Interpretation is limited by the retrospective single-center design, inclusion of surgically treated patients only, and nonstandardized chart-based assessment of symptoms and psychological impact.