A new scoring system for coronary artery abnormalities in Kawasaki disease

Background In China, coronary artery abnormalities (CAAs) secondary to Kawasaki disease (KD) tend to have an increased occurrence. We hypothesize that Chinese children with KD may possess several unique CAA risks, and the predictive efficacy of multiple scoring systems in Chinese patients are still to be further studied. Methods Two hundred and three KD patients were recruited. Using multivariable analysis, independent predictors of CAAs were combined into a scoring system. Subsequently, CAA risks of our patients were evaluated by the newly established scoring system and eight other published scoring systems. Results Seventeen (8.37%) KD patients were identified as CAAs. The newly established scoring system contained the following 5 independent predictors: days of illness at initial treatment >= 7, redness and swelling of extremities, hematocrit <= 33%, percentage of monocytes >= 8.89%, and procalcitonin >= 0.5 ng/mL. The AUC value of newly established scoring system was 0.685 with a sensitivity of 41.18% and a specificity of 84.41%, higher than Harada score, Egami score, Kobayashi score, Sato score, San Diego score, Formosa score, and Tang score, whereas lower than Hua score. Conclusions Days of illness at initial treatment >= 7 and procalcitonin are unique predictors of CAAs in newly established scoring system. Taking into account different identification criteria and analytical methodologies, there is still some heterogeneity among different scoring systems. Impact The newly established scoring system contains the five independent predictors. Days of illness at initial treatment >= 7 and PCT are unique predictors of CAAs in our study, compared with 8 other systems. The AUC value of newly established scoring system is 0.685, similar to Hua score. There is some heterogeneity among different scoring systems.

Automated summary

The study identified days of illness at initial treatment >= 7 and procalcitonin as unique predictors of CAAs in Chinese children with Kawasaki disease. The newly established scoring system showed higher sensitivity and specificity compared to existing scoring systems, but there is still some heterogeneity among them.