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.
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