Department of Pediatric Cardiology, University of Health Science, Kanuni Sultan Süleyman Training and Research Hospital; İstanbul-Turkey.
Department of Pediatrics, University of Health Science, Kanuni Sultan Süleyman Training and Research Hospital; İstanbul-Turkey.
Anatol J Cardiol. 2020 Aug;24(2):97-106. doi: 10.14744/AnatolJCardiol.2020.37560.
Kawasaki disease (KD) is the most common cause of coronary artery aneurysm (CAA) in children. The available risk scores to predict intravenous immunoglobulin (IVIG) resistance and CAA were developed in Asian populations in whom their effectiveness has been proven, but data on non-Asian children are limited. This study aimed to evaluate the ability of 5 risk scoring systems to predict IVIG resistance and CAA in Turkey patients with KD.
Patients with KD were retrospectively evaluated with clinical, laboratory, and echocardiographic findings. Data analyses were performed in 5 scoring systems (Harada, Kobayashi, Egami, Formosa, and Sano).
A total of 259 patients (Male: Female, 1.7) were treated for KD in our hospital. The mean age of diagnosis in patients with KD, CAA, and IVIG resistance were 3.31, 2.19, and 2.06, respectively. CAA development and IVIG resistance were seen in 11.6% and 12.3% of cases, respectively. IVIG resistance was detected in 35.6% of patients with CAA. In our study, 5 risk scoring systems were applied to our patients. ROC analysis results were found highest in Kobayashi scoring system for IVIG resistance (AUC, 0.864) and in Harada scoring system for CAA development (AUC, 0.727).
Harada score was significant in predicting CAA risk, and Kobayashi score was significant in predicting the risk of developing IVIG resistance. It is necessary to determine more specific and sensitive risk scores that increase the risk of IVIG resistance and the development of CAA in Turkey.
川崎病（KD）是儿童冠状动脉瘤（CAA）最常见的病因。现有的预测静脉注射免疫球蛋白（IVIG）抵抗和 CAA 的风险评分是在亚洲人群中开发的，其有效性已得到证实，但非亚洲儿童的数据有限。本研究旨在评估 5 种风险评分系统在预测土耳其川崎病患者 IVIG 抵抗和 CAA 中的能力。
对 KD 患者的临床、实验室和超声心动图检查结果进行回顾性评估。在 5 种评分系统（原田、小林、江田、福摩萨和佐野）中进行数据分析。
共有 259 例（男：女，1.7）在我院接受 KD 治疗。KD、CAA 和 IVIG 抵抗患者的平均诊断年龄分别为 3.31、2.19 和 2.06。CAA 发生和 IVIG 抵抗分别见于 11.6%和 12.3%的病例。CAA 患者中有 35.6%出现 IVIG 抵抗。在本研究中，将 5 种风险评分系统应用于我们的患者。ROC 分析结果发现，小林评分系统对 IVIG 抵抗的预测效果最佳（AUC，0.864），而原田评分系统对 CAA 发展的预测效果最佳（AUC，0.727）。
原田评分系统对 CAA 风险的预测有意义，小林评分系统对 IVIG 抵抗风险的预测有意义。有必要确定更具体和敏感的风险评分，以增加土耳其 IVIG 抵抗和 CAA 发展的风险。
