Risk factors for coronary arterial involvement in Turkish children with Kawasaki disease: a multicenter retrospective study
Background. Coronary arterial lesions (CALs) are the major component of Kawasaki disease (KD), associated with significant morbidity, which affect a substantial proportion of patients despite proper treatment. The aim of this study was to define the risk factors for CALs in Turkish children w...
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| Language: | English |
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Hacettepe University Institute of Child Health
2023-02-01
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| Series: | The Turkish Journal of Pediatrics |
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| Online Access: | https://turkjpediatr.org/article/view/8 |
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| author | Serkan Türkuçar Seza Özen Nurettin Ünal Tevfik Karagöz Özgür Kasapçopur Betül Sözeri Nuray Aktay Ayaz Yelda Bilginer Balahan Makay Erdem Karabulut Ferhat Demir Fatih Haşlak Figen Çakmak Ümmüşen Akça Kaya Erbil Ünsal |
| author_facet | Serkan Türkuçar Seza Özen Nurettin Ünal Tevfik Karagöz Özgür Kasapçopur Betül Sözeri Nuray Aktay Ayaz Yelda Bilginer Balahan Makay Erdem Karabulut Ferhat Demir Fatih Haşlak Figen Çakmak Ümmüşen Akça Kaya Erbil Ünsal |
| author_sort | Serkan Türkuçar |
| collection | DOAJ |
| description |
Background. Coronary arterial lesions (CALs) are the major component of Kawasaki disease (KD), associated with significant morbidity, which affect a substantial proportion of patients despite proper treatment. The aim of this study was to define the risk factors for CALs in Turkish children with KD.
Methods. Medical records of 399 KD patients from five pediatric rheumatology centers in Turkey were reviewed retrospectively. Demographic, clinical (including duration of fever before intravenous immunoglobulin [IVIG] and resistance to IVIG), laboratory and echocardiographic data were noted.
Results. The patients with CALs were younger, had a higher male ratio and a longer duration of fever before IVIG. They also had higher lymphocyte and lower hemoglobin values before the initial treatment. Multiple logistic regression analyses defined the following three criteria as independent risk factors for predicting CALs in Turkish children with KD: age ≤12 months, male gender and duration of fever before IVIG ≥9.5 days. High sensitivity rates of elevated risk of CALs up to 94.5% were calculated despite specificity values falling to 16.5%, depending on which of these three parameters are taken into account.
Conclusions. Based on the demographic and clinical features, we established an easily applicable risk-scoring system for predicting CALs in Turkish children with KD. This may be useful for choosing appropriate treatment and follow-up for KD to prevent coronary artery involvement. Further studies will show whether these risk factors can be used in other Caucasian populations as well.
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| format | Article |
| id | doaj-art-ab14f3e7c9d44a2d950f11335eac0f97 |
| institution | OA Journals |
| issn | 0041-4301 2791-6421 |
| language | English |
| publishDate | 2023-02-01 |
| publisher | Hacettepe University Institute of Child Health |
| record_format | Article |
| series | The Turkish Journal of Pediatrics |
| spelling | doaj-art-ab14f3e7c9d44a2d950f11335eac0f972025-08-20T02:00:55ZengHacettepe University Institute of Child HealthThe Turkish Journal of Pediatrics0041-43012791-64212023-02-0165110.24953/turkjped.2021.1132Risk factors for coronary arterial involvement in Turkish children with Kawasaki disease: a multicenter retrospective studySerkan Türkuçar0Seza Özen1Nurettin Ünal2Tevfik Karagöz3Özgür Kasapçopur4Betül Sözeri5Nuray Aktay Ayaz6Yelda Bilginer7Balahan Makay8Erdem Karabulut9Ferhat Demir10Fatih Haşlak11Figen Çakmak12Ümmüşen Akça Kaya13Erbil Ünsal14Department of Pediatric Rheumatology, Dokuz Eylül University Faculty of Medicine, İzmir.Department of Pediatric Rheumatology, Hacettepe University Faculty of Medicine, Ankara.Department of Pediatric Cardiology, Dokuz Eylül University Faculty of Medicine, İzmir, Türkiye.Department of Pediatric Cardiology, Hacettepe University Faculty of Medicine, Ankara.Department of Pediatric Rheumatology, İstanbul University Cerrahpaşa Faculty of Medicine, İstanbul.Department of Pediatric Rheumatology, Ümraniye Training and Research Hospital, İstanbul.Department of Pediatric Rheumatology, İstanbul University Çapa Faculty of Medicine, İstanbul.Department of Pediatric Rheumatology, Hacettepe University Faculty of Medicine, Ankara.Department of Pediatric Rheumatology, Dokuz Eylül University Faculty of Medicine, İzmir.Department of Biostatistics, Hacettepe University Faculty of Medicine, Ankara.Department of Pediatric Rheumatology, Ümraniye Training and Research Hospital, İstanbul.Department of Pediatric Rheumatology, İstanbul University Cerrahpaşa Faculty of Medicine, İstanbul.Department of Pediatric Rheumatology, İstanbul University Çapa Faculty of Medicine, İstanbul.Department of Pediatric Rheumatology, Hacettepe University Faculty of Medicine, Ankara.Department of Pediatric Rheumatology, Dokuz Eylül University Faculty of Medicine, İzmir. Background. Coronary arterial lesions (CALs) are the major component of Kawasaki disease (KD), associated with significant morbidity, which affect a substantial proportion of patients despite proper treatment. The aim of this study was to define the risk factors for CALs in Turkish children with KD. Methods. Medical records of 399 KD patients from five pediatric rheumatology centers in Turkey were reviewed retrospectively. Demographic, clinical (including duration of fever before intravenous immunoglobulin [IVIG] and resistance to IVIG), laboratory and echocardiographic data were noted. Results. The patients with CALs were younger, had a higher male ratio and a longer duration of fever before IVIG. They also had higher lymphocyte and lower hemoglobin values before the initial treatment. Multiple logistic regression analyses defined the following three criteria as independent risk factors for predicting CALs in Turkish children with KD: age ≤12 months, male gender and duration of fever before IVIG ≥9.5 days. High sensitivity rates of elevated risk of CALs up to 94.5% were calculated despite specificity values falling to 16.5%, depending on which of these three parameters are taken into account. Conclusions. Based on the demographic and clinical features, we established an easily applicable risk-scoring system for predicting CALs in Turkish children with KD. This may be useful for choosing appropriate treatment and follow-up for KD to prevent coronary artery involvement. Further studies will show whether these risk factors can be used in other Caucasian populations as well. https://turkjpediatr.org/article/view/8Kawasaki diseaseTurkish childrencoronary arterial involvementintravenous immunoglobulinrisk factors |
| spellingShingle | Serkan Türkuçar Seza Özen Nurettin Ünal Tevfik Karagöz Özgür Kasapçopur Betül Sözeri Nuray Aktay Ayaz Yelda Bilginer Balahan Makay Erdem Karabulut Ferhat Demir Fatih Haşlak Figen Çakmak Ümmüşen Akça Kaya Erbil Ünsal Risk factors for coronary arterial involvement in Turkish children with Kawasaki disease: a multicenter retrospective study The Turkish Journal of Pediatrics Kawasaki disease Turkish children coronary arterial involvement intravenous immunoglobulin risk factors |
| title | Risk factors for coronary arterial involvement in Turkish children with Kawasaki disease: a multicenter retrospective study |
| title_full | Risk factors for coronary arterial involvement in Turkish children with Kawasaki disease: a multicenter retrospective study |
| title_fullStr | Risk factors for coronary arterial involvement in Turkish children with Kawasaki disease: a multicenter retrospective study |
| title_full_unstemmed | Risk factors for coronary arterial involvement in Turkish children with Kawasaki disease: a multicenter retrospective study |
| title_short | Risk factors for coronary arterial involvement in Turkish children with Kawasaki disease: a multicenter retrospective study |
| title_sort | risk factors for coronary arterial involvement in turkish children with kawasaki disease a multicenter retrospective study |
| topic | Kawasaki disease Turkish children coronary arterial involvement intravenous immunoglobulin risk factors |
| url | https://turkjpediatr.org/article/view/8 |
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