A new scoring system to predict Kawasaki disease with coronary artery lesions
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To clarify the independent risk factors and construct a scoring system for Kawasaki disease (KD) with coronary artery lesions (CAL) at acute and subacute stages.
Data of KD inpatients at acute and subacute stages were reviewed in a tertiary care center from January 2009 to December 2014.
A total of 2305 acute and subacute KD cases were enrolled in this study with a CAL rate of 24.1%. The OR (95%CI) values of male, total fever duration ≥ 8 days, IVIG resistance (IVIGR), albumin (ALB) ≤ 35.9 g/L, eosionphils (EO) ≥ 2.2%, and monocytes (MO) ≥ 5.9% were 1.45 (1.15–1.82), 1.78 (1.43–2.22), 1.42 (1.09–1.85), 1.53 (1.23–1.91), 1.17 (0.94–1.45), and 1.37 (1.09–1.69), respectively. In patients ≤ 6 months old, the OR (95%CI) values for total fever duration ≥8 days, delayed diagnosis, and ALB ≤ 35.9 g/L were 3.61 (2.02–6.45), 3.49 (1.49–8.16), and 2.07 (1.14–3.74), respectively. ROC curve showed that the AUC value and sensitivity and specificity of predicting KD with CAL in patients ≤ 6 months old were 0.731, 64.7%, and 80.9%, respectively.
The independent risk factors for acute and subacute KD combined with CAL, including being a boy, long fever duration, IVIGR, low ALB, elevated EO, and MO. Joint of parameters (total fever duration ≥ 8 days, delayed diagnosis, and ALB ≤ 35.9 g/L) can be used to predict the occurrence of CAL in KD patients ≤ 6 months old.
KeywordsCoronary artery lesions Kawasaki disease Scoring systems
This work is supported, in part, by grants from the National Natural Science Foundation of China (No. 81670251), Natural Science Foundation of Zhejiang Province (No. LY16H020001), and Research Foundation of Health Bureau of Zhejiang Province (No. 2016KYB175).
Compliance with ethical standards
The retrospective studies have been approved by the ethics committee in our hospital and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.
- 9.Minich LL, Sleeper LA, Atz AM, McCrindle BW, Lu M, Colan SD, Printz BF, Klein GL, Sundel RP, Takahashi M, Li JS, Vetter VL, Newburger JW (2007) Delayed diagnosis of Kawasaki disease: what are the risk factors. Pediatrics 120(6):e1434–e1440. https://doi.org/10.1542/peds.2007-0815 CrossRefGoogle Scholar
- 11.Wang Y, Wang W, Gong F, Fu S, Zhang Q, Hu J, Qi Y, Xie C, Zhang Y (2013) Evaluation of intravenous immunoglobulin resistance and coronary artery lesions in relation to Th1/Th2 cytokine profiles in patients with Kawasaki disease. Arthritis Rheum 65(3):805–814. https://doi.org/10.1002/art.37815 CrossRefGoogle Scholar
- 14.Belay ED, Maddox RA, Holman RC, Curns AT, Ballah K, Schonberger LB (2006) Kawasaki syndrome and risk factors for coronary artery abnormalities: United States, 1994-2003. Pediatr Infect Dis J 25(3):245–249. https://doi.org/10.1097/01.inf.0000202068.30956.16 CrossRefGoogle Scholar
- 16.Du ZD, Zhao D, Du J, Zhang YL, Lin Y, Liu C, Zhang T (2007) Epidemiologic study on Kawasaki disease in Beijing from 2000 through 2004. Pediatr Infect Dis J 26(5):449–451. https://doi.org/10.1097/01.inf.0000261196.79223.18 CrossRefGoogle Scholar
- 17.Ma XJ, Yu CY, Huang M, Chen SB, Huang MR, Huang GY (2010) Epidemiologic features of Kawasaki disease in Shanghai from 2003 through 2007. Chin Med J 123(19):2629–2634Google Scholar
- 22.Asadi-Pooya AA, Borzoee M, Amoozgar H (2006) The experience with 113 patients with Kawasaki disease in Fars Province, Iran. Turk J Pediatr 48(2):109–114Google Scholar
- 26.Suzuki H, Takeuchi T, Minami T, Shibuta S, Uemura S, Yoshikawa N (2003) Water retention in the acute phase of Kawasaki disease: relationship between oedema and the development of coronary arterial lesions. Eur J Pediatr 162(12):856–859. https://doi.org/10.1007/s00431-003-1326-4 CrossRefGoogle Scholar
- 27.Kawamura Y, Takeshita S, Kanai T, Yoshida Y, Nonoyama S (2016) The combined usefulness of the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in predicting intravenous immunoglobulin resistance with Kawasaki disease. J Pediatr 178:281–284.e1. https://doi.org/10.1016/j.jpeds.2016.07.035 CrossRefGoogle Scholar