Inability of Asian risk scoring systems to predict intravenous immunoglobulin resistance and coronary lesions in Kawasaki disease in an Italian cohort

Fabi, Marianna; Andreozzi, Laura; Corinaldesi, Elena; Bodnar, Tetyana; Lami, Francesca; Cícero, Cristina; Tchana, Bertrand; Landini, Chiara; Sprocati, Monica; Bigucci, Barbara; Balsamo, Claudia; Valin, Paola Sogno; Fazzio, Giorgia Di; Iughetti, Lorenzo; Valletta, Enrico; Marchetti, Federico; Donti, Andrea; Lanari, Marcello

doi:10.1007/s00431-018-3297-5

Cited by 57 publications

(45 citation statements)

References 24 publications

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“…It is important to identify risk factors that increase the risk of developing CALs. Over the years, researchers have developed various scoring methods to predict the risk of complications and aggressive treatment in patients with KD ( 5 , 9 - 12 , 21 ).…”

Section: Discussionmentioning

confidence: 99%

How useful are Kawasaki disease risk scoring systems to the Turkish population?

2020

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Objective: Kawasaki disease (KD) is the most common cause of coronary artery aneurysm (CAA) in children. The available risk scores to predict intravenous immunoglobulin (IVIG) resistance and CAA were developed in Asian populations in whom their effectiveness has been proven, but data on non-Asian children are limited. This study aimed to evaluate the ability of 5 risk scoring systems to predict IVIG resistance and CAA in Turkey patients with KD. Methods: Patients with KD were retrospectively evaluated with clinical, laboratory, and echocardiographic findings. Data analyses were performed in 5 scoring systems (Harada, Kobayashi, Egami, Formosa, and Sano). Results: A total of 259 patients (Male: Female, 1.7) were treated for KD in our hospital. The mean age of diagnosis in patients with KD, CAA, and IVIG resistance were 3.31, 2.19, and 2.06, respectively. CAA development and IVIG resistance were seen in 11.6% and 12.3% of cases, respectively. IVIG resistance was detected in 35.6% of patients with CAA. In our study, 5 risk scoring systems were applied to our patients. ROC analysis results were found highest in Kobayashi scoring system for IVIG resistance (AUC, 0.864) and in Harada scoring system for CAA development (AUC, 0.727). Conclusion: Harada score was significant in predicting CAA risk, and Kobayashi score was significant in predicting the risk of developing IVIG resistance. It is necessary to determine more specific and sensitive risk scores that increase the risk of IVIG resistance and the development of CAA in Turkey.

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Section: Discussionmentioning

confidence: 99%

How useful are Kawasaki disease risk scoring systems to the Turkish population?

2020

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“…Assuming that both research methods were appropriately and strictly designed, we may presume that an unknown ongoing process involved nutrition status, in addition to vascular inflammation. However, early validation research on Japan scoring models yield inconsistent result between different races [2,[22][23][24]. It showed multiple ethnicityexclusive models are required.…”

Section: Pni Predicts Kd With Caa and Ivig Non-respondermentioning

confidence: 99%

Prognostic nutrition index as a predictor of coronary artery aneurysm in Kawasaki Disease

Tai

Guo

et al. 2020

BMC Pediatr

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Background: Kawasaki Disease (KD) is considered a major acquired heart disease in children under the age of 5. Coronary artery aneurysm (CAA) can occur in serious cases despite extreme therapy efforts. Previous studies have reported low serum albumin level was associated with disease outcome, but no further investigation was addressed yet. Method: This retrospective (case-control) study randomly included children with KD who were admitted and underwent laboratory tests before undergoing IVIG treatment in this institution, the largest tertiary medical center in southern Taiwan from 2012 to 2016. Prognostic nutrition index (PNI), an albumin-based formula product, was evaluated as a predictor of CAA the first time. The progression of CAA was monitored using serial echocardiography for six months. We performed multivariable logistic regression analysis on the laboratory test and PNI with the disease outcome of the KD patients. Result: Of the 275 children, 149 had CAA, including transient dilatation, while the other 126 did not develop CAA during the 6-month follow-up period. A multivariate logistic regression model revealed that PNI, gender, IVIG nonresponder, and platelet count are significant predictors of CAA with a 95% confidence interval estimator of 1.999, 3.058, 3.864 and 1.004, respectively. Using PNI to predict CAA presence gave an area under the receiver-operatingcharacteristics (ROC) curve of 0.596. For a cutoff of 0.5 in the logistic regression model and the PNI cutoff point is taken as 55 together with IVIG non-responder, boy gender, and platelet count take into account, sensitivity and specificity were 65.7 and 70.4%. Conclusion: PNI could be a candidate of adjunctive predictor of coronary artery aneurysm in addition to IVIG nonresponder. Together with low PNI, IVIG non-responder, male gender and platelet count will give high odds to predict coronary artery aneurysm within 6 months of illness.

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“…Assuming that both research methods were appropriately and strictly designed, we may presume that an unknown ongoing process involved nutrition status, in addition to vascular inflammation. However, early validation research on Japan scoring models yield inconsistent result between different races (2,(22)(23)(24). It showed multiple ethnicity-exclusive models are required.…”

Section: Pni Predicts Kd With Caa and Ivig Non-respondermentioning

confidence: 99%

Prognostic nutrition index as a predictor of coronary artery aneurysm in Kawasaki Disease

Tai

Guo

et al. 2020

Preprint

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Background: Kawasaki Disease (KD) is considered a major acquired heart disease in children under the age of 5. Coronary artery aneurysm (CAA) can occur in serious cases despite extreme therapy efforts. Previous studies have reported low serum albumin level was associated with disease outcome, but no further investigation was addressed yet. Method: This retrospective (case-control) study randomly included children with KD who were admitted and underwent laboratory tests before undergoing IVIG treatment in this institution, the largest tertiary medical center in southern Taiwan from 2012-2016. Prognostic nutrition index (PNI), an albumin-based formula product, was evaluated as a predictor of CAA the first time. The progression of CAA was monitored using serial echocardiography for six months. We performed multivariable logistic regression analysis on the laboratory test and PNI with the disease outcome of the KD patients. Result: Of the 275 children, 149 had CAA, including transient dilatation, while the other 126 did not develop CAA during the 6-month follow-up period. A multivariate logistic regression model revealed that PNI, gender, IVIG non-responder, and platelet count are significant predictors of CAA with a 95% confidence interval estimator of 1.999, 3.058, 3.864 and1.004, respectively. Using PNI to predict CAA presence gave an area under the receiver-operating-characteristics (ROC) curve of 0.596. For a cutoff of 0.5 in the logistic regression model and the PNI cut-off point is taken as 55 together with IVIG non-responder, boy gender, and platelet count take into account, sensitivity and specificity were 65.7% and 70.4%. Conclusion: PNI could be a candidate of adjunctive predictor of coronary artery aneurysm in addition to IVIG non-responder. Together with low PNI, IVIG non-responder, male gender and platelet count will give high odds to predict coronary artery aneurysm within 6 months of illness.

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Inability of Asian risk scoring systems to predict intravenous immunoglobulin resistance and coronary lesions in Kawasaki disease in an Italian cohort

Cited by 57 publications

References 24 publications

How useful are Kawasaki disease risk scoring systems to the Turkish population?

How useful are Kawasaki disease risk scoring systems to the Turkish population?

Prognostic nutrition index as a predictor of coronary artery aneurysm in Kawasaki Disease

Prognostic nutrition index as a predictor of coronary artery aneurysm in Kawasaki Disease

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