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Epidemiologic features and prognostic factors of coronary artery lesions associated with Kawasaki disease based on a 13-year cohort of consecutive cases identified by complete enumeration surveys in Wakayama, Japan.

Kitano N, Suzuki H, Takeuchi T, Suenaga T, Kakimoto N, Shibuta S, Yoshikawa N, Takeshita T, Wakayama Kawasaki Disease Study Gro - J Epidemiol (2014)

Bottom Line: The ORs of CALs among patients <11 months old (3.0, 95% CI 1.4-6.6) and those >48 months old (3.1, 95% CI 1.5-6.6) were significantly higher than values in 11- to 48-month-olds.The effect of patient age on the development of CALs was found to be U-shaped, with the bottom at ages 11 to 48 months.This finding was based on a 13-year cohort of consecutive KD cases in a specific area with little selection bias and is consistent with previously reported results.

View Article: PubMed Central - PubMed

Affiliation: Department of Public Health, School of Medicine, Wakayama Medical University.

ABSTRACT

Background: To clarify the contribution of patient age to the development of coronary artery lesions (CALs) associated with Kawasaki disease (KD), epidemiologic features and prognostic factors were investigated using hospital-based complete enumeration surveys in a specific area.

Methods: Consecutive KD cases identified between October 1999 and September 2012 in Wakayama Prefecture, Japan, were analyzed. The primary outcome measure was the presence/absence of CALs (giant aneurysm, mid- or small-sized aneurysm, and dilatation) on echocardiography 1 month after disease onset. Demographics and medical treatment factors were compared between the patients with and without CALs. Odds ratios (ORs) and 95% confidence intervals (CIs) of explanatory variables (age, gender, and factors related to high-dose intravenous immunoglobulin treatment) for the development of CALs were determined.

Results: The median age of the 1415 patients (796 males, 619 females) was 25 months after excluding 2 children of foreign residents; 2.2% of the patients had a past history of KD, and 1.8% showed incomplete presentation. CALs were observed in 3.3% (4.0% of males, 2.3% of females; P = 0.080). The ORs of CALs among patients <11 months old (3.0, 95% CI 1.4-6.6) and those >48 months old (3.1, 95% CI 1.5-6.6) were significantly higher than values in 11- to 48-month-olds.

Conclusions: The effect of patient age on the development of CALs was found to be U-shaped, with the bottom at ages 11 to 48 months. This finding was based on a 13-year cohort of consecutive KD cases in a specific area with little selection bias and is consistent with previously reported results.

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Related in: MedlinePlus

The distribution of the number of patients with KD from October 1999 to September 2012 by the four categories of initial IVIG treatment regimen (n = 1415).
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fig01: The distribution of the number of patients with KD from October 1999 to September 2012 by the four categories of initial IVIG treatment regimen (n = 1415).

Mentions: The percentage who received IVIG treatment was 91.9% (1301/1415). The yearly distribution of the number of patients with KD is shown by the four categories of initial IVIG regimen (Figure). There were no significant differences across these four treatment regimen groups with respect to the patients’ gender, age at disease onset, or recurrence, but a significant difference in the groups’ proportions of incomplete presentation was observed (P < 0.001) (Table 1). Regarding the number of illness days when initial IVIG was started, 4.0% (57/1415) started at >7 illness days, which included 12 complete presentation cases starting at ≥10 illness days but none of the incomplete presentation cases.


Epidemiologic features and prognostic factors of coronary artery lesions associated with Kawasaki disease based on a 13-year cohort of consecutive cases identified by complete enumeration surveys in Wakayama, Japan.

Kitano N, Suzuki H, Takeuchi T, Suenaga T, Kakimoto N, Shibuta S, Yoshikawa N, Takeshita T, Wakayama Kawasaki Disease Study Gro - J Epidemiol (2014)

The distribution of the number of patients with KD from October 1999 to September 2012 by the four categories of initial IVIG treatment regimen (n = 1415).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4150015&req=5

fig01: The distribution of the number of patients with KD from October 1999 to September 2012 by the four categories of initial IVIG treatment regimen (n = 1415).
Mentions: The percentage who received IVIG treatment was 91.9% (1301/1415). The yearly distribution of the number of patients with KD is shown by the four categories of initial IVIG regimen (Figure). There were no significant differences across these four treatment regimen groups with respect to the patients’ gender, age at disease onset, or recurrence, but a significant difference in the groups’ proportions of incomplete presentation was observed (P < 0.001) (Table 1). Regarding the number of illness days when initial IVIG was started, 4.0% (57/1415) started at >7 illness days, which included 12 complete presentation cases starting at ≥10 illness days but none of the incomplete presentation cases.

Bottom Line: The ORs of CALs among patients <11 months old (3.0, 95% CI 1.4-6.6) and those >48 months old (3.1, 95% CI 1.5-6.6) were significantly higher than values in 11- to 48-month-olds.The effect of patient age on the development of CALs was found to be U-shaped, with the bottom at ages 11 to 48 months.This finding was based on a 13-year cohort of consecutive KD cases in a specific area with little selection bias and is consistent with previously reported results.

View Article: PubMed Central - PubMed

Affiliation: Department of Public Health, School of Medicine, Wakayama Medical University.

ABSTRACT

Background: To clarify the contribution of patient age to the development of coronary artery lesions (CALs) associated with Kawasaki disease (KD), epidemiologic features and prognostic factors were investigated using hospital-based complete enumeration surveys in a specific area.

Methods: Consecutive KD cases identified between October 1999 and September 2012 in Wakayama Prefecture, Japan, were analyzed. The primary outcome measure was the presence/absence of CALs (giant aneurysm, mid- or small-sized aneurysm, and dilatation) on echocardiography 1 month after disease onset. Demographics and medical treatment factors were compared between the patients with and without CALs. Odds ratios (ORs) and 95% confidence intervals (CIs) of explanatory variables (age, gender, and factors related to high-dose intravenous immunoglobulin treatment) for the development of CALs were determined.

Results: The median age of the 1415 patients (796 males, 619 females) was 25 months after excluding 2 children of foreign residents; 2.2% of the patients had a past history of KD, and 1.8% showed incomplete presentation. CALs were observed in 3.3% (4.0% of males, 2.3% of females; P = 0.080). The ORs of CALs among patients <11 months old (3.0, 95% CI 1.4-6.6) and those >48 months old (3.1, 95% CI 1.5-6.6) were significantly higher than values in 11- to 48-month-olds.

Conclusions: The effect of patient age on the development of CALs was found to be U-shaped, with the bottom at ages 11 to 48 months. This finding was based on a 13-year cohort of consecutive KD cases in a specific area with little selection bias and is consistent with previously reported results.

Show MeSH
Related in: MedlinePlus