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...

Full description

Saved in:
Bibliographic Details
Main Authors: 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
Format: Article
Language:English
Published: Hacettepe University Institute of Child Health 2023-02-01
Series:The Turkish Journal of Pediatrics
Subjects:
Online Access:https://turkjpediatr.org/article/view/8
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850240146368102400
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.
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
work_keys_str_mv AT serkanturkucar riskfactorsforcoronaryarterialinvolvementinturkishchildrenwithkawasakidiseaseamulticenterretrospectivestudy
AT sezaozen riskfactorsforcoronaryarterialinvolvementinturkishchildrenwithkawasakidiseaseamulticenterretrospectivestudy
AT nurettinunal riskfactorsforcoronaryarterialinvolvementinturkishchildrenwithkawasakidiseaseamulticenterretrospectivestudy
AT tevfikkaragoz riskfactorsforcoronaryarterialinvolvementinturkishchildrenwithkawasakidiseaseamulticenterretrospectivestudy
AT ozgurkasapcopur riskfactorsforcoronaryarterialinvolvementinturkishchildrenwithkawasakidiseaseamulticenterretrospectivestudy
AT betulsozeri riskfactorsforcoronaryarterialinvolvementinturkishchildrenwithkawasakidiseaseamulticenterretrospectivestudy
AT nurayaktayayaz riskfactorsforcoronaryarterialinvolvementinturkishchildrenwithkawasakidiseaseamulticenterretrospectivestudy
AT yeldabilginer riskfactorsforcoronaryarterialinvolvementinturkishchildrenwithkawasakidiseaseamulticenterretrospectivestudy
AT balahanmakay riskfactorsforcoronaryarterialinvolvementinturkishchildrenwithkawasakidiseaseamulticenterretrospectivestudy
AT erdemkarabulut riskfactorsforcoronaryarterialinvolvementinturkishchildrenwithkawasakidiseaseamulticenterretrospectivestudy
AT ferhatdemir riskfactorsforcoronaryarterialinvolvementinturkishchildrenwithkawasakidiseaseamulticenterretrospectivestudy
AT fatihhaslak riskfactorsforcoronaryarterialinvolvementinturkishchildrenwithkawasakidiseaseamulticenterretrospectivestudy
AT figencakmak riskfactorsforcoronaryarterialinvolvementinturkishchildrenwithkawasakidiseaseamulticenterretrospectivestudy
AT ummusenakcakaya riskfactorsforcoronaryarterialinvolvementinturkishchildrenwithkawasakidiseaseamulticenterretrospectivestudy
AT erbilunsal riskfactorsforcoronaryarterialinvolvementinturkishchildrenwithkawasakidiseaseamulticenterretrospectivestudy