Department of Pediatrics, University of Kansas School of Medicine, Wichita, Kansas.
University of Oklahoma, Oklahoma City, Oklahoma.
Hosp Pediatr. 2022 Mar 1;12(3):257-266. doi: 10.1542/hpeds.2021-006142.
To explore trends in hospitalization rate, resource use, and outcomes of Kawasaki Disease (KD) in children in the United States from 2008 to 2017.
This was a retrospective, serial cross-sectional analysis of pediatric hospitalizations with International Classification of Disease diagnostic codes for KD in the National Inpatient Sample. Hospitalization rates per 100 000 populations were calculated and stratified by age group, gender, race, and US census region. Prevalence of coronary artery aneurysms (CAA) were expressed as proportions of KD hospitalizations. Resource use was defined in terms of length of stay and hospital cost. Cochran-Armitage and Jonckheere-Terpstra trend tests were used for categorical and continuous variables, respectively. P <.05 was considered significant.
A total of 43 028 pediatric hospitalizations identified with KD, yielding an overall hospitalization rate of 5.5 per 100 000 children. The overall KD hospitalization rate remained stable over the study period (P = .18). Although KD hospitalization rates differed by age group, gender, race, and census region, a significant increase was observed among Native Americans (P = .048). Rates of CAA among KD hospitalization increased from 2.4% to 6.8% (P = .04). Length of stay remained stable at 2 to 3 days, but inflation-adjusted hospital cost increased from $6819 in 2008 to $10 061 in 2017 (Ptrend < 0.001).
Hospitalization-associated costs and rates of CAA diagnostic codes among KD hospitalizations increased, despite a stable KD hospitalization rate between 2008 and 2017. These findings warrant further investigation and confirmation with databases with granular clinical information.
探究 2008 年至 2017 年美国儿童川崎病（KD）住院率、资源利用和结局的变化趋势。
本研究采用回顾性、连续横断面分析方法，利用国家住院患者样本中 KD 的国际疾病分类诊断代码，对儿科住院患者进行分析。每 10 万人的住院率通过计算得出，并按年龄组、性别、种族和美国人口普查区域进行分层。冠状动脉瘤（CAA）的患病率用 KD 住院患者的比例表示。资源利用用住院时间和住院费用来定义。分类变量和连续变量分别采用 Cochran-Armitage 和 Jonckheere-Terpstra 趋势检验。P<0.05 为差异有统计学意义。
共纳入 43028 例 KD 儿科住院患者，KD 总住院率为 5.5/10 万儿童。研究期间 KD 总住院率保持稳定（P=0.18）。尽管 KD 住院率因年龄组、性别、种族和人口普查区域而异，但在美洲原住民中观察到显著增加（P=0.048）。KD 住院患者中 CAA 的发生率从 2.4%增加到 6.8%（P=0.04）。住院时间保持在 2 至 3 天，但经通胀调整的住院费用从 2008 年的 6819 美元增加到 2017 年的 10061 美元（Ptrend<0.001）。
尽管 2008 年至 2017 年 KD 住院率保持稳定，但与 KD 住院相关的成本和 CAA 诊断代码的发生率增加。这些发现需要进一步的研究和具有详细临床信息的数据库进行确认。
