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Published on: June 16, 2014
Older age is a risk factor for the development of cardiovascular sequelae in Kawasaki disease
Hiromi Muta1, Masahiro Ishii, Takahiko Sakaue
1Department of Pediatrics, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan. qze05346@nifty.com
Insights
Older children with Kawasaki disease (KD) have a higher risk of cardiovascular problems. This study found that age is an independent risk factor for developing these serious complications.
Area of Science:
- Pediatrics
- Cardiology
- Immunology
Background:
- Kawasaki disease (KD) is a critical pediatric illness.
- Understanding KD characteristics in older children is essential for timely diagnosis and treatment.
- Cardiovascular sequelae remain a significant concern in KD management.
Purpose of the Study:
- To investigate the clinical features of Kawasaki disease in children aged 6 years and older.
- To assess if older age is a risk factor for developing cardiovascular abnormalities in KD patients.
Main Methods:
- Analysis of 1,498 patients from Japan's 16th nationwide KD survey (1999-2000).
- Matched pairs comparing children aged 6+ years (older group) with those aged 6 months to 3 years (younger group).
- Statistical analysis including multivariate logistic regression to identify risk factors.
Main Results:
- Older children showed a higher incidence of recurrent KD (9% vs 2%).
- Fewer older children received timely intravenous gamma-globulin treatment (82% vs 87%).
- A greater proportion of older children developed cardiovascular abnormalities (20% vs 15%), with older age identified as an independent risk factor (OR: 1.58).
Conclusions:
- Age is an independent risk factor for cardiovascular sequelae in children diagnosed with Kawasaki disease.
- Delayed treatment and increased cardiovascular risks highlight the need for heightened awareness in older KD patients.
- Further research into age-specific KD management strategies is warranted.
Objectives:
To clarify the characteristics of Kawasaki disease (KD) in children 6 years and older and to determine whether age is a risk factor for cardiovascular abnormalities.
Methods:
Patients who had KD and were reported between 1999 and 2000 in the 16th nationwide survey of KD in Japan (n = 15,314) were analyzed. Patients who were aged 6 years or older (older group) were matched with patients who were aged 6 months to 3 years and were treated at the same hospital (younger groups). The total number of analyzed patients was 1498 (749 matched pairs).
Results:
The proportion of complete KD in the older group was similar to that in the younger group. Recurrent cases in the older group were significantly more common than those in the younger group (9% vs 2%). The proportion of patients who were treated with intravenous gamma-globulin in the older group was significantly lower than that in the younger group (82% vs 87%). The proportion of older group patients who were treated with intravenous gamma-globulin at or after 7 days of illness was significantly higher than that in the younger group (35% vs 14%). There was a higher prevalence of cardiovascular abnormalities in the older group than in the younger group (20% vs 15%). Multivariate logistic regression analysis showed that older age was an independent risk factor for cardiovascular sequelae (odds ratio: 1.58; 95% confidence interval: 1.01-2.46).
Conclusions:
In children older than 6 years, age is an independent risk factor for cardiovascular sequelae in KD.
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