Division of Pediatric Cardiology, Stollery Children's Hospital, University of Alberta Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada.
Division of Pediatric Cardiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington.
Hosp Pediatr. 2022 Mar 1;12(3):248-257. doi: 10.1542/hpeds.2021-006308.
To prospectively evaluate the long-term impact of Kawasaki disease (KD) hospitalization on health-related quality of life (HRQoL).
We merged the Outcomes Assessment Program and KD databases and queried for KD admissions between 1 month and 18 years of age. Patients with a diagnosis of community-acquired pneumonia were included as a comparison group. HRQoL was evaluated with the parent proxy Pediatric Quality of Life Inventory (PedsQL). Long-term follow-up PedsQL surveys were performed at least 1 year after initial diagnosis and hospitalization. Results for the entire cohort adjusted for significant differences were calculated. Propensity score-matched cohorts were constructed from the unmatched cohorts of patients with long-term survey responses. Subgroup analysis for the KD group was performed.
Patients with KD (n = 61) versus pneumonia (n = 80) had a lower PedsQL total score on admission and experienced a significantly greater HRQoL decline from baseline to admission. At long-term follow-up, no difference occurred in HRQoL between patients with KD and pneumonia, and 89% of patients with KD reached their baseline PedsQL scores. KD diagnostic subtype, coronary artery dilatation, and need for longer follow-up were not associated with HRQoL outcomes at any time point. Intravenous immunoglobulin nonresponders demonstrated lower HRQoL at admission, which did not persist at follow-up.
Children with KD experience acute and significant HRQoL impairment exceeding that of children with newly diagnosed pneumonia, but the scores return to baseline at long-term follow-up. The recoveries at short- and long-term intervals are similar to patients with pneumonia.
前瞻性评估川崎病（KD）住院对健康相关生活质量（HRQoL）的长期影响。
我们合并了 Outcomes Assessment Program 和 KD 数据库，并查询了 1 个月至 18 岁的 KD 住院患者。将社区获得性肺炎诊断患者作为对照组。采用家长代理的儿童生活质量量表（PedsQL）评估 HRQoL。在初始诊断和住院后至少 1 年进行长期随访 PedsQL 调查。对整个队列进行了调整，以消除显著差异。从无长期调查反应的患者的未匹配队列中构建了倾向评分匹配队列。对 KD 组进行了亚组分析。
KD 组（n=61）与肺炎组（n=80）相比，入院时 PedsQL 总分较低，且基线至入院时 HRQoL 下降幅度显著较大。在长期随访中，KD 组与肺炎组的 HRQoL 无差异，89%的 KD 患者达到了基线 PedsQL 评分。KD 诊断亚型、冠状动脉扩张和需要更长时间随访与任何时间点的 HRQoL 结果均无关。静脉注射免疫球蛋白无反应者入院时 HRQoL 较低，但在随访时并未持续。
KD 患儿在急性和显著的 HRQoL 受损方面超过了新诊断为肺炎的患儿，但在长期随访时可恢复至基线。在短期和长期随访期间的恢复情况与肺炎患者相似。
