A new model for predicting intravenous immunoglobin-resistant Kawasaki disease in Chongqing: a retrospective study on 5277 patients

• Published in: Scientific reports Vol. 9; no. 1; p. 1722
• Main Authors: Tan, Xu-Hai, Zhang, Xiao-Wei, Wang, Xiao-Yun, He, Xiang-Qian, Fan, Chu, Lyu, Tie-Wei, Tian, Jie
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 11.02.2019; Nature Publishing Group
• Subjects: 692/4023/1670/427; 692/499; 692/700/1720/3187; Albumin; Coronary artery; Erythrocytes; Humanities and Social Sciences; Immunoglobulins; Intravenous administration; Kawasaki disease; Lymphocytes; Mucocutaneous lymph node syndrome; multidisciplinary; Patients; Prediction models; Regression analysis; Risk factors; Science; Science (multidisciplinary); Sodium
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-019-39330-y

Accurate evaluation of individual risk of intravenous immunoglobin (IVIG)-resistance is critical for adopting regimens for the first treatment and prevention of coronary artery lesions (CALs) in patients with Kawasaki disease (KD). Methods: The KD patients hospitalized in Chongqing Children’s Hospital, in west China, from October 2007 to December 2017 were retrospectively reviewed. Data were collected and compared between IVIG-resistant group and IVIG-responsive group. The independent risk factors were determined using multivariate regression analysis. A new prediction model was built and compared with the previous models. Results: A total of 5277 subjects were studied and eight independent risk factors were identified including higher red blood cell distribution width (RDW), lower platelet count (PLT), lower percentage of lymphocyte (P-LYM), higher total bile acid (TBA), lower albumin, lower serum sodium level, higher degree of CALs (D-CALs) and younger age. The new predictive model showed an AUC of 0.74, sensitivity of 76% and specificity of 59%. For individual’s risk probability of IVIG-resistance, an equation was given. Conclusions: IVIG-resistance could be predicted by RDW, PLT, P-LYM, TBA, albumin, serum sodium level, D-CALs and age. The new model appeared to be superior to those previous models for KD population in Chongqing city.