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Usefulness of Kawasaki disease risk scoring systems to the Turkish population

Kazım Öztarhan1, Yusuf Ziya Varlı2, Nuray Aktay Ayaz3

  • 1Department of Pediatric Cardiology, University of Health Science, Kanuni Sultan Süleyman Training and Research Hospital; İstanbul-Turkey.

Anatolian Journal of Cardiology
|August 5, 2020
PubMed

Insights

The Harada score effectively predicts coronary artery aneurysm (CAA) risk, while the Kobayashi score predicts intravenous immunoglobulin (IVIG) resistance in children with Kawasaki disease (KD). Further research is needed for more specific risk scores in Turkey.

Area of Science:

  • Pediatric Cardiology
  • Immunology
  • Rheumatology

Background:

  • Kawasaki disease (KD) is a leading cause of acquired heart disease in children, often leading to coronary artery aneurysms (CAA).
  • Intravenous immunoglobulin (IVIG) is a standard treatment, but predicting resistance is crucial for optimal management.
  • Existing risk scores for IVIG resistance and CAA were developed primarily in Asian populations, with limited validation in other ethnicities.

Purpose of the Study:

  • To evaluate the predictive accuracy of five established risk scoring systems for IVIG resistance and CAA development in Turkish children with KD.
  • To assess the applicability of Harada, Kobayashi, Egami, Formosa, and Sano scores in a non-Asian pediatric population.

Main Methods:

  • A retrospective analysis of 259 pediatric patients diagnosed with KD.
  • Evaluation of clinical, laboratory, and echocardiographic data.
  • Application and ROC analysis of five risk scoring systems (Harada, Kobayashi, Egami, Formosa, Sano).

Main Results:

  • Coronary artery aneurysm (CAA) developed in 11.6% and IVIG resistance in 12.3% of patients.
  • The Kobayashi score demonstrated the highest accuracy for predicting IVIG resistance (AUC, 0.864).
  • The Harada score showed the highest accuracy for predicting CAA development (AUC, 0.727).

Conclusions:

  • The Harada score is significant for predicting CAA risk, and the Kobayashi score for predicting IVIG resistance in this Turkish cohort.
  • Current risk scores show moderate predictive ability, highlighting the need for developing more specific and sensitive scores for the Turkish population.
  • Tailored risk stratification tools are essential to improve outcomes for children with KD in Turkey.
Abstract

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