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A new scoring system to predict Kawasaki disease with coronary artery lesions

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Abstract

Objectives

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.

Method

Data of KD inpatients at acute and subacute stages were reviewed in a tertiary care center from January 2009 to December 2014.

Results

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.

Conclusions

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.

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Funding

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).

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Author notes

  1. Wang Hua and Feiyue Ma contributed equally to this work.

Authors and Affiliations

  1. Department of Cardiology, Children’s Hospital, Zhejiang University School of Medicine, No. 3333, Binsheng Road, Hangzhou, 310052, People’s Republic of China

    Wang Hua, Feiyue Ma, Ying Wang, Songling Fu, Wei Wang, Chunhong Xie, Yiying Zhang & Fangqi Gong

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  1. Wang Hua
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Correspondence to Fangqi Gong.

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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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Hua, W., Ma, F., Wang, Y. et al. A new scoring system to predict Kawasaki disease with coronary artery lesions. Clin Rheumatol 38, 1099–1107 (2019). https://doi.org/10.1007/s10067-018-4393-7

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