Skip to main content
Top
Published in:

01-06-2025 | Kawasaki Disease | RESEARCH

Development of a predictive model for the progression of Kawasaki disease: a retrospective analysis of clinical and echocardiographic data

Authors: Hongqiang Yin, Ruijuan Su, Dongmei Liu, Yawen Deng, Ning Ma

Published in: European Journal of Pediatrics | Issue 6/2025

Login to get access

Abstract

This study aimed to identify risk factors for the progression of coronary artery lesions (CALs) in children with Kawasaki disease (KD) and to establish a nomogram for predicting this risk. We retrospectively analyzed clinical and echocardiographic data from KD patients diagnosed at Beijing Children’s Hospital from 1 January 2021 to 30 December 2023.The patients were categorized into the progression and non-progression groups on the basis of coronary artery Z-scores and diameters at the 1-month follow-up compared with baseline. Univariate logistic regression identified significant indicators, supplemented by factors from the literature. We used full permutation to examine potential combinations, followed by multivariate logistic regression to calculate the Akaike information criterion (AIC) and area under the curve (AUC) for each model. We selected the best values for establishing a prediction score and nomogram. Model performance was assessed using the AUC, calibration curves, and tenfold cross-validation. Among 1249 patients, 183 (14.7%) experienced progression of CALs, while 1066 (85.3%) showed improvement or stability. Eight independent factors were identified: the baseline maximum Z-score, age, percentage of neutrophils, hemoglobin concentrations, erythrocyte sedimentation rate, albumin, fibrinogen, and intravenous immunoglobulin resistance. The nomogram model showed an AUC of 0.788, with a mean AUC of 0.775 and an accuracy of 85.6% after tenfold cross-validation.
Conclusion: The baseline maximum Z-score, age, percentage of neutrophils, hemoglobin concentrations, erythrocyte sedimentation rate, albumin, fibrinogen, and intravenous immunoglobulin resistance are predictive factors for CALs progression in KD. The established nomogram shows high accuracy and reliability, aiding clinicians in decision-making.
What is known:
Since the introduction of IVIG therapy, most children with KD show CALs regression, yet a subset experience progressive CALs despite treatment.
CALs progression is associated with increased adverse cardiovascular events, yet predictors of this progression remain poorly characterized.
What is new:
The eight-factor predictive model developed in this study effectively identifies progression risks in CALs following treatment, providing a basis for personalized clinical management.
Echocardiography, the primary modality for assessing coronary arteries in children, demonstrates that early baseline Z-score evaluation serves as the strongest predictor for CALs progression, while non-coronary cardiac abnormalities show no significant association.
Literature
This content is only visible if you are logged in and have the appropriate permissions.
Metadata
Title
Development of a predictive model for the progression of Kawasaki disease: a retrospective analysis of clinical and echocardiographic data
Authors
Hongqiang Yin
Ruijuan Su
Dongmei Liu
Yawen Deng
Ning Ma
Publication date
01-06-2025
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Pediatrics / Issue 6/2025
Print ISSN: 0340-6199
Electronic ISSN: 1432-1076
DOI
https://doi.org/10.1007/s00431-025-06181-x

Keynote webinar | Spotlight on adolescent vaping

Growing numbers of young people are using e-cigarettes, despite warnings of respiratory effects and addiction. How can doctors tackle the epidemic, and what health effects should you prepare to manage in your clinics?

Prof. Ann McNeill
Dr. Debbie Robson
Benji Horwell
Developed by: Springer Medicine
Watch now
Video