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

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.