Scoring method for identifying patients with Kawasaki disease at high risk of coronary artery aneurysms

Nakano, Hiroyuki; Ueda, Ken; Saito, Akihiro; Tsuchitani, Y; Kawamori, Juzou; Miyake, Teruki; Yoshida, Takami

doi:10.1016/0002-9149(86)90348-6

Cited by 49 publications

(20 citation statements)

References 8 publications

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“…Among the total patients reported in this survey, 12.1% were found to suffer from a cardiac sequela as defined previously. Some believe that the cardiac sequelae of Kawasaki disease are responsible for the development of atherosclerosis in adulthood.…”

supporting

confidence: 58%

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Effects of Gamma-Globulin on the Cardiac Sequelae of Kawasaki Disease

Yanagawa¹,

Zhang²,

Oki³

et al. 1999

Pediatr Cardiol

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Our aim was to delineate the effect of various factors, such as sex, age, serum albumin levels, and the timing of gamma-globulin (GG) therapy, on cardiac sequelae of Kawasaki disease. The patients with Kawasaki disease who were reported at the 1995-1996 nationwide survey and received 2000 mg/kg at specified hospitals were selected as the subjects of the study. A total of 2221 patients actually received the basic dose. The relationships of the GG therapy with the cardiac sequelae, sex, age, timing of GG administration (the date of initiation and duration of the regimen following disease onset), and serum albumin levels were examined by using logistic regression analysis. The odds ratios for the cardiac sequelae in patients with Kawasaki disease were high in males (1.63), in those under the age of 1 year (1.54), and in those with a serum albumin level <3.2 g/dl (2.64). The odds ratio was low in those who received GG before day 8 of the illness (0.69) or in those for whom the administration period was for 2 days or less (0.67). To prevent cardiac sequelae of Kawasaki disease it is desirable that GG therapy be started as soon as possible and completed within 2 days.

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supporting

confidence: 58%

“…), delay in the start of treatment (a lapse of 1 week or more before the start of therapy), and gammaglobulin (GG) dose (inadequate dose) [1,[5][6][7][8][9]12]. We conducted an analysis on the factors associated with the development of cardiac sequelae based on the epidemiologic data that were obtained from a nationwide survey on Kawasaki disease.…”

mentioning

confidence: 99%

Effects of Gamma-Globulin on the Cardiac Sequelae of Kawasaki Disease

Yanagawa¹,

Zhang²,

Oki³

et al. 1999

Pediatr Cardiol

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“…Scoring models for predicting CAA devised by Nakano et al 15 and by Iwasa et al 16 have not been verified using multicenter data; they also require repeated laboratory tests over several days before treatment. Beiser et al 17 also reported a predictive instrument of CAA based on a large multicenter trial.…”

Section: Discussionmentioning

confidence: 99%

Prediction of Intravenous Immunoglobulin Unresponsiveness in Patients With Kawasaki Disease

Kobayashi

Inoue²,

Takeuchi³

et al. 2006

Circulation

735

710

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Background-In the present study, we developed models to predict unresponsiveness to intravenous immunoglobulin (IVIG) in Kawasaki disease (KD). Methods and Results-We reviewed clinical records of 546 consecutive KD patients (development dataset) and 204 subsequent KD patients (validation dataset). All received IVIG for treatment of KD. IVIG nonresponders were defined by fever persisting beyond 24 hours or recrudescent fever associated with KD symptoms after an afebrile period. A 7-variable logistic model was constructed, including day of illness at initial treatment, age in months, percentage of white blood cells representing neutrophils, platelet count, and serum aspartate aminotransferase, sodium, and C-reactive protein, which generated an area under the receiver-operating-characteristics curve of 0.84 and 0.90 for the development and validation datasets, respectively. Using both datasets, the 7 variables were used to generate a simple scoring model that gave an area under the receiver-operating-characteristics curve of 0.85. For a cutoff of 0.15 or more in the logistic regression model and 4 points or more in the simple scoring model, sensitivity and specificity were 86% and 67% in the logistic model and 86% and 68% in the simple scoring model. The kappa statistic is 0.67, indicating good agreement between the logistic and simple scoring models. Conclusions-Our predictive models showed high sensitivity and specificity in identifying IVIG nonresponders among KD patients.

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“…The retrospective study which looked at risk factors for refractory KD in Japan resulted that in 20% of cases who did not respond to initial IVIG therapy, risk factors associated with the need for retreatment were initial treatment on/before the fifth day of illness, recurrent episodes of KD and male gender) (25). A scoring system by Nakano H. et al used age, CRP and platelet count to predict and determine the patients with higher chance for coronary problems (27). In a study by sleeper LA et al in eight centers in North America the most consistent variables as independent risk factors for IVIG retreatment model included male gender, lower albumin, and higher AST (c-statistic 0.83).…”

Section: Discussionmentioning

confidence: 99%

The Relationship Between Severity of Kawasaki Disease and History of Ischemic Heart Disease in the Parents

Shirvani

Saket

Karimi

et al. 2016

Arch Pediatr Infect Dis

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Background: Kawasaki disease (KD) is the most important cause of ischemic heart disease in children. Its pathogenesis is not well understood, but geographic, ethnic and familial pattern of this syndrome is reported. Ischemic heart disease (IHD) in parents can be the result of KD in their children. This is a study on the prevalence of IHD in parents of children with severe and non-severe Kawasaki disease. Objectives: The current study aimed to estimate the prevalence of IHD in the families of children with KD. Patients and Methods: Sixty-one children with Kawasaki disease were admitted from December 21, 2004 to January 21, 2008to Mofid Children Hospital (from one month to thirteen-year old) and 50 patients entered the study. Subjects were divided into the severe (24subjects) and non-severe (26 subjects) groups. All of the parents were called for investigation. Data were analyzed by SPSS ver. 21 software.

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Scoring method for identifying patients with Kawasaki disease at high risk of coronary artery aneurysms

Cited by 49 publications

References 8 publications

Effects of Gamma-Globulin on the Cardiac Sequelae of Kawasaki Disease

Effects of Gamma-Globulin on the Cardiac Sequelae of Kawasaki Disease

Prediction of Intravenous Immunoglobulin Unresponsiveness in Patients With Kawasaki Disease

The Relationship Between Severity of Kawasaki Disease and History of Ischemic Heart Disease in the Parents

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