Department of Pediatrics, the First Affiliated Hospital of Yangtze University, Jingzhou, Hubei Province, China.
J Int Med Res. 2023 Feb;51(2):3000605221139704. doi: 10.1177/03000605221139704.
This case-control study focused on the establishment and internal validation of a risk nomogram for intravenous immunoglobulin (IVIG)-resistant Kawasaki disease (KD) using the Kawasaki Disease Database.
The Kawasaki Disease Database is the first public database for KD researchers. A prediction nomogram for IVIG-resistant KD was constructed using multivariable logistic regression. Then, the C-index was used to assess the discriminating ability of the proposed prediction model, a calibration plot was drawn to evaluate its calibration, and a decision curve analysis was adopted to assess its clinical usefulness. Bootstrapping validation was performed for interval validation.
The median ages of IVIG-resistant and -sensitive KD groups were 3.3 and 2.9 years, respectively. Predicting factors incorporated into the nomogram were coronary artery lesions, C-reactive protein, percentage of neutrophils, platelets, aspartate aminotransferase, and alanine transaminase. Our constructed nomogram exhibited favorable discriminating ability (C-index: 0.742; 95% confidence interval: 0.673-0.812) and excellent calibration. Moreover, interval validation achieved a high C-index of 0.722.
The as-constructed new IVIG-resistant KD nomogram that incorporated C-reactive protein, coronary artery lesions, platelets, percentage of neutrophils, alanine transaminase, and aspartate aminotransferase may be adopted for predicting the risk of IVIG-resistant KD.
本病例对照研究使用川崎病数据库，旨在建立并内部验证静脉注射免疫球蛋白（IVIG）抵抗川崎病（KD）的风险列线图。
川崎病数据库是川崎病研究人员的第一个公共数据库。使用多变量逻辑回归构建 IVIG 抵抗 KD 的预测列线图。然后，使用 C 指数评估提出的预测模型的区分能力，绘制校准图评估其校准度，并采用决策曲线分析评估其临床实用性。进行bootstrap 验证以进行区间验证。
IVIG 抵抗和敏感 KD 组的中位数年龄分别为 3.3 岁和 2.9 岁。纳入列线图的预测因素包括冠状动脉病变、C 反应蛋白、中性粒细胞百分比、血小板、天冬氨酸转氨酶和丙氨酸转氨酶。我们构建的列线图具有良好的区分能力（C 指数：0.742；95%置信区间：0.673-0.812）和良好的校准度。此外，区间验证实现了 0.722 的高 C 指数。
纳入 C 反应蛋白、冠状动脉病变、血小板、中性粒细胞百分比、丙氨酸转氨酶和天冬氨酸转氨酶的新 IVIG 抵抗 KD 列线图可能被用于预测 IVIG 抵抗 KD 的风险。
