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Evaluation of a Kawasaki Disease Risk Model for Predicting Coronary Artery Aneurysms in a Japanese Population: An Analysis of Post RAISE.
Miyata, Koichi; Miura, Masaru; Kaneko, Tetsuji; Morikawa, Yoshihiko; Matsushima, Takahiro; Sakakibara, Hiroshi; Misawa, Masahiro; Kobayashi, Tohru; Yamagishi, Hiroyuki.
Afiliação
  • Miyata K; Department of Cardiology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
  • Miura M; Department of Cardiology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan; Clinical Research Support Center, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan. Electronic address: masaru10miura@gmail.com.
  • Kaneko T; Clinical Research Support Center, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan; Teikyo Academic Research Center, Teikyo University, Tokyo, Japan.
  • Morikawa Y; Clinical Research Support Center, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
  • Matsushima T; Department of General Pediatrics, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
  • Sakakibara H; Department of General Pediatrics, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
  • Misawa M; Department of Pediatrics, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan.
  • Kobayashi T; Department of Data Science, Clinical Research Center, National Center for Child Health and Development, Tokyo, Japan.
  • Yamagishi H; Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan.
J Pediatr ; 237: 96-101.e3, 2021 Oct.
Article em En | MEDLINE | ID: mdl-34147499
OBJECTIVES: To test the performance of the Son risk score, which was created to predict coronary artery abnormalities from baseline variables in North American patients with Kawasaki disease. STUDY DESIGN: The dataset from Post RAISE, the largest prospective cohort study of Japanese patients with Kawasaki disease to date, was used for the present study. With high risk defined as ≥3 points, sensitivity, specificity, positive predictive value, and negative predictive value for coronary artery abnormality development were calculated. To evaluate the effect of each risk factor in the Son score, the OR and 95% CIs were calculated using logistic regression analysis with the presence of coronary artery abnormality at 1 month after disease onset. RESULTS: Post RAISE enrolled 2628 consecutive patients with Kawasaki disease, and 304 patients had a high-risk score, of whom 15.1% showed coronary artery abnormality. At the cutoff ≥3 points, the sensitivity was 37.7%, and the specificity was 87.2%. The maximum z score at baseline ≥2.0 (OR 3.5, 95% CI 2.3-5.2) and age <6 months at disease onset (OR 3.2, 95% CI 1.9-5.4), were significantly associated with coronary artery abnormality development. However, a high concentration of C-reactive protein was not associated with coronary artery abnormality. The area under the receiver operating characteristic curve for the Son score was 0.65 (95% CI 0.59-0.71). CONCLUSIONS: The Son score had insufficient sensitivity and good specificity in a Japanese cohort of patients with Kawasaki disease. Among the variables comprising the Son score, a large baseline z score and young age at disease onset were significant, independent predictors of coronary artery abnormality development.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Índice de Gravidade de Doença / Aneurisma Coronário / Regras de Decisão Clínica / Síndrome de Linfonodos Mucocutâneos Tipo de estudo: Clinical_trials / Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Child / Child, preschool / Female / Humans / Infant / Male País/Região como assunto: Asia Idioma: En Revista: J Pediatr Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Japão País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Índice de Gravidade de Doença / Aneurisma Coronário / Regras de Decisão Clínica / Síndrome de Linfonodos Mucocutâneos Tipo de estudo: Clinical_trials / Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Child / Child, preschool / Female / Humans / Infant / Male País/Região como assunto: Asia Idioma: En Revista: J Pediatr Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Japão País de publicação: Estados Unidos