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J Epidemiol. 2014;24(5):427-34. Epub 2014 Jul 5.

Epidemiologic features and prognostic factors of coronary artery lesions associated with Kawasaki disease based on a 13-year cohort of consecutive cases identified by complete enumeration surveys in Wakayama, Japan.

Author information

1
Department of Public Health, School of Medicine, Wakayama Medical University.

Abstract

BACKGROUND:

To clarify the contribution of patient age to the development of coronary artery lesions (CALs) associated with Kawasaki disease (KD), epidemiologic features and prognostic factors were investigated using hospital-based complete enumeration surveys in a specific area.

METHODS:

Consecutive KD cases identified between October 1999 and September 2012 in Wakayama Prefecture, Japan, were analyzed. The primary outcome measure was the presence/absence of CALs (giant aneurysm, mid- or small-sized aneurysm, and dilatation) on echocardiography 1 month after disease onset. Demographics and medical treatment factors were compared between the patients with and without CALs. Odds ratios (ORs) and 95% confidence intervals (CIs) of explanatory variables (age, gender, and factors related to high-dose intravenous immunoglobulin treatment) for the development of CALs were determined.

RESULTS:

The median age of the 1415 patients (796 males, 619 females) was 25 months after excluding 2 children of foreign residents; 2.2% of the patients had a past history of KD, and 1.8% showed incomplete presentation. CALs were observed in 3.3% (4.0% of males, 2.3% of females; P = 0.080). The ORs of CALs among patients <11 months old (3.0, 95% CI 1.4-6.6) and those >48 months old (3.1, 95% CI 1.5-6.6) were significantly higher than values in 11- to 48-month-olds.

CONCLUSIONS:

The effect of patient age on the development of CALs was found to be U-shaped, with the bottom at ages 11 to 48 months. This finding was based on a 13-year cohort of consecutive KD cases in a specific area with little selection bias and is consistent with previously reported results.

PMID:
24998951
PMCID:
PMC4150015
DOI:
10.2188/jea.je20140018
[Indexed for MEDLINE]
Free PMC Article

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