Risk Factors for Coronary Aneurysm in Kawasaki Disease in Central Thailand
Pentip Supachokchaiwattana,1 Sasitorn Vibulwatanakij1
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The most important complication of Kawasaki disease is coronary aneurysm (CA). The purpose of this study is to identify risk factors for coronary aneurysm in patients with Kawasaki disease treated at Sawanpracharak hospital during October 2006 to November 2011. Methods:
Clinical, laboratory and treatment of patients diagnosed with Kawasaki disease were reviewed and categorized into two groups, CA (+) and CA (-) group. Clinical variables of interest were compared between the two groups and independent risk factors for coronary aneurysm were analyzed using a cluster logistic regression model. Results:
A total of 67 patients were diagnosed with Kawasaki disease, of these,11 patients developed coronary aneurysm (16.4%). The CA (+) group had higher white blood cell counts, higher platelet counts, longer time from onset of disease to start of IVIG (IVIGd), lower hematocrit levels, and lower serum albumin. Cluster logistic regression was applied by dividing patients into 3 age groups, less than 12, 12-60months, and over 60 months. Risk factors for coronary aneurysm were: total neutrophil count > 12,000 / mm (OR = 15.46, 95%CI 5.56-43.00, p<0.001), erythrocyte sedimentation rate (ESR) >80 mm/ hr (OR = 5.00, 95%CI 2.60-9.64, p < 0.001), IVIGd > 8 days (OR 17.04, 95%CI 6.45-45.03, p < 0.001). Area under the curve (ROC) was 0.8807. Conclusion:
Comparing patients with Kawasaki disease at the same age group, risk factors for coronary aneurysm were total neutrophil count > 12,000 / mm3, ESR > 80 mm/ hr and time from onset of disease to start of IVIG ≥ 8 days. When these risk factors are found in patients with Kawasaki disease, physicians should closely monitor these patients, give timely treatment, and consider early referral to a pediatric cardiologist.Keywords
coronary aneurysm - Kawasaki disease - risk factor
Correspondence to Pentip Supachokchaiwattana, MD, Department of Pediatrics. Sawanpracharak Hospital. Nakhonsawan. Thailand. Telephone: (+665) 621 9888. Fax: (+665) 621 9899. E-mail: [email protected] Open Access: This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
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