|
KMID : 0377520180430010015
|
|
Chung-Ang Journal of Medicine
2018 Volume.43 No. 1 p.15 ~ p.21
|
|
|
Clinical Efficacy of Stratified Management Protocol Using a Risk Prediction Model in Kawasaki Disease
|
|
Kim Yoo-Na
Lee Eun-Hye
Yoon Kyung-Rim
Han Mi-Young
|
|
|
Abstract
|
|
|
Purpose: Although Kawasaki disease (KD) is a leading cause of acquired heart disease in children, a universal treatment protocol has yet to be established. This study was conducted to investigate the clinical utility of risk prediction model in the stratified management protocol of KD patients.
Methods: Data of patients with KD were collected from two affiliated centers, Kyung Hee University Hospital and Kyung Hee University Hospital at Gangdong, from January 2015 to March 2017. Exclusion criteria were as follows: whose diagnosis was recurrent Kawasaki disease, who received initial therapy at other hospital, who were either younger than 100 days or older than six years (72 months), and who were lost to follow-up. Patients are designated into two groups (group A and B) depending on whether the Kobayashi risk stratification model was used. Demographic characteristics, lab data, and patient charts were reviewed, and serial echocardiography was performed. As a primary outcome, patients' coronary artery z-scores were calculated using the McCrindle method and compared. All data were compared using SPSS v. 24, and a p-value of <0.05 was considered statistically significant.
Results: After applying exclusion criteria, 98 patients were finally included. Demographic characteristics of sex, age, and laboratory data were not significantly different between the two groups, and there were no differences in fever duration and hospitalization period. However, group A had lower z-scores over time compared to group B, with statistically significant differences (p <0.05).
Conclusion: This study suggested that initial KD risk stratification may direct selective management protocol and reduce coronary artery complications. These findings may be useful to optimize the management and outcomes of patients with KD.
|
|
|
KEYWORD
|
|
|
Coronary z-score, Kawasaki disease, Kobayashi, Risk prediction model
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|
|