Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Feb;78(2):121-6.
doi: 10.1016/j.jcma.2014.03.009. Epub 2015 Jan 28.

Epidemiologic features of Kawasaki disease in acute stages in Taiwan, 1997-2010: effect of different case definitions in claims data analysis

Ming-Chih Lin  1 , Mei-Shu Lai  2 , Sheng-Ling Jan  3 , Yun-Ching Fu  4
Affiliations

Epidemiologic features of Kawasaki disease in acute stages in Taiwan, 1997-2010: effect of different case definitions in claims data analysis

Ming-Chih Lin et al. J Chin Med Assoc. 2015 Feb.

Abstract

Background: Kawasaki disease is the leading cause of pediatric acquired cardiac disease in many industrialized countries. The aim of this study was to estimate the incidence of Kawasaki disease in acute stages in Taiwan, by linking the diagnosis code to medication and comparing the differences in epidemiological features with those of previous reports that used the diagnosis code alone.

Methods: We searched the National Health Insurance Research Database from 1997 to 2010. For the International Classification of Diseases, Ninth Revision (ICD-9) set, all inpatients with a main diagnosis of Kawasaki disease (ICD-9, 446.1) were retrieved. For the ICD-9 + intravenous immunoglobulin (IVIG) set, Kawasaki disease in acute stages was defined as the disease stages requiring IVIG. The epidemiologic features were calculated and compared by both methods.

Results: The incidence rates for children under 5 years ranged from 21.5 to 68.5 per 100,000 person-years (average 49.1) for the ICD-9 + IVIG set and from 48.5 to 82.8 per 100,000 person-years (average 74.9) for the ICD-9 set. Significant discrepancy in peak season estimation occurred in summer. The 5-year recurrence rate was 1.1% for the ICD-9 + IVIG set and 4.5% for the ICD-9 set. The coronary complication rates were around 7.24% (ICD-9 + IVIG) and 6.48% (ICD-9).

Conclusion: Discrepancies occurred when different case definitions were used in claims data analysis. Previous reports might have overestimated the incidence, recurrence rate, and complication rate in older children. The new method might slightly underestimate them. The true incidence might lie in between.

Keywords: Kawasaki disease; claims data; epidemiology; seasonal variations.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Cumulative recurrence rates of Kawasaki disease calculated by different case definitions. ICD-9 = International Classification of Diseases, Ninth Revision; IVIG = intravenous immunoglobulin.
Fig. 2
Fig. 2
Proportions of patients with coronary aneurysm in different age groups, using the ICD-9 data alone or the ICD-9 + IVIG data. ICD-9 = International Classification of Diseases, Ninth Revision; IVIG = intravenous immunoglobulin.
See this image and copyright information in PMC

References

    1. Newburger J.W., Takahashi M., Gerber M.A., Gewitz M.H., Tani L.Y., Burns J.C. Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Pediatrics. 2004;114:1708–1733. - PubMed
    1. Du Z.D., Zhao D., Du J., Zhang Y.L., Lin Y., Liu C. Epidemiologic study on Kawasaki disease in Beijing from 2000 through 2004. Pediatr Infect Dis J. 2007;26:449–451. - PubMed
    1. Fischer T.K., Holman R.C., Yorita K.L., Belay E.D., Melbye M., Koch A. Kawasaki syndrome in Denmark. Pediatr Infect Dis J. 2007;26:411–415. - PubMed
    1. Heaton P., Wilson N., Nicholson R., Doran J., Parsons A., Aiken G. Kawasaki disease in New Zealand. J Paediatr Child Health. 2006;42:184–190. - PubMed
    1. Holman R.C., Belay E.D., Christensen K.Y., Folkema A.M., Steiner C.A., Schonberger L.B. Hospitalizations for Kawasaki syndrome among children in the United States, 1997–2007. Pediatr Infect Dis J. 2010;29:483–488. - PubMed

Publication types