Incidence and short-term outcomes of Kawasaki disease

Cal Robinson¹, Rahul Chanchlani^{2

3

4}, Anastasia Gayowsky⁴, Sandeep Brar⁵, Elizabeth Darling⁶, Catherine Demers⁷, Jennifer Klowak¹, Braden Knight^{8

9}, Ellen Kuenzig^{8

9}, Tapas Mondal¹⁰, Rulan Parekh¹¹, Hsien Seow¹², Carolina Jimenez-Rivera^{9

13

14}, Richard Webster⁹, Stephen Fung⁹, Eric I Benchimol^{8

9

13

14

15}, Michelle Batthish¹⁶

Affiliations

¹ Department of Pediatrics, McMaster University, Hamilton, ON, Canada.
² Division of Pediatric Nephrology, Department of Pediatrics, McMaster University, Hamilton, ON, Canada.
³ Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
⁴ ICES McMaster, Hamilton, ON, Canada.
⁵ Department of Epidemiology & Biostatistics, University of California, San Francisco, CA, USA.
⁶ McMaster Midwifery Research Centre, McMaster University, Hamilton, ON, Canada.
⁷ Department of Medicine, Division of Cardiology, McMaster University, Hamilton, ON, Canada.
⁸ ICES Ottawa, Ottawa, ON, Canada.
⁹ Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.
¹⁰ Division of Pediatric Cardiology, Department of Pediatrics, McMaster University, Hamilton, ON, Canada.
¹¹ Division of Pediatric Nephrology, Department of Pediatrics, University of Toronto, Toronto, ON, Canada.
¹² Department of Oncology, McMaster University, Hamilton, ON, Canada.
¹³ Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.
¹⁴ Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada.
¹⁵ School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
¹⁶ Division of Pediatric Rheumatology, Department of Pediatrics, McMaster University, Hamilton, ON, Canada. batthim@mcmaster.ca.

PMID: 33785879
DOI: 10.1038/s41390-021-01496-5

Incidence and short-term outcomes of Kawasaki disease

Cal Robinson et al. Pediatr Res. 2021 Sep.

. 2021 Sep;90(3):670-677.

doi: 10.1038/s41390-021-01496-5. Epub 2021 Mar 30.

Authors

Affiliations

¹ Department of Pediatrics, McMaster University, Hamilton, ON, Canada.
² Division of Pediatric Nephrology, Department of Pediatrics, McMaster University, Hamilton, ON, Canada.
³ Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
⁴ ICES McMaster, Hamilton, ON, Canada.
⁵ Department of Epidemiology & Biostatistics, University of California, San Francisco, CA, USA.
⁶ McMaster Midwifery Research Centre, McMaster University, Hamilton, ON, Canada.
⁷ Department of Medicine, Division of Cardiology, McMaster University, Hamilton, ON, Canada.
⁸ ICES Ottawa, Ottawa, ON, Canada.
⁹ Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.
¹⁰ Division of Pediatric Cardiology, Department of Pediatrics, McMaster University, Hamilton, ON, Canada.
¹¹ Division of Pediatric Nephrology, Department of Pediatrics, University of Toronto, Toronto, ON, Canada.
¹² Department of Oncology, McMaster University, Hamilton, ON, Canada.
¹³ Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.
¹⁴ Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada.
¹⁵ School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
¹⁶ Division of Pediatric Rheumatology, Department of Pediatrics, McMaster University, Hamilton, ON, Canada. batthim@mcmaster.ca.

PMID: 33785879
DOI: 10.1038/s41390-021-01496-5

Abstract

Objective: Kawasaki disease (KD) is a childhood vasculitis with conflicting reported North American trends in incidence and patient characteristics.

Objectives: (1) determine KD incidence between 1995 and 2017; (2) compare patient characteristics by era and age group; (3) determine complication and cardiovascular follow-up rates.

Methods: We used population-based health administrative data to identify children (0-18 yr) hospitalized with KD in Ontario, Canada between 1995 and 2017. We excluded children with prior KD diagnosis or incomplete records. We determined the annualized incidence and follow-up trends.

Results: KD was diagnosed in 4,346 children between 1995 and 2017. Annual KD incidence was 22.0 (<5 yr), 6.1 (5-9 yr), and 0.6 (10-18 yr) per 100,000 children. KD incidence increased significantly for all age groups, including from 18.4 to 25.0 cases per 100,000 children <5 yr. Ninety-day mortality occurred in ≤5 children (≤0.1%). Coronary artery aneurysm (CAA) occurred in 106 children (2.4%, 95% confidence interval 2.0-2.9) during admission and 151 (3.5%, 95% confidence interval 3.0-4.1) during 11-year median follow-up. Children 10-18 yr had longer hospitalizations (4.3 vs. 3.5 days, p = 0.003) and more CAA (7.4% vs. 3.4%, p = 0.007). By 1-year post-diagnosis, 3970 (91.3%) and 2576 (59.3%) children had echocardiography and cardiology follow-up, respectively.

Conclusions: KD incidence is increasing in Ontario, with greater healthcare utilization from hospitalizations and subsequent follow-up.

Impact: 4346 children were hospitalized for Kawasaki disease over 22 years in Ontario, and Kawasaki disease incidence increased significantly for all age groups, males and females. Older children (10-18 years) had longer hospital length of stay, more PICU admissions and more frequent coronary artery aneurysms. Nearly all children with Kawasaki disease had follow-up echocardiography within 1 year.

PubMed Disclaimer

References

1. Burgner, D. & Harnden, A. Kawasaki disease: what is the epidemiology telling us about the etiology? Int. J. Infect. Dis. 9, 185–194 (2005). - DOI
1. Taubert, K. A., Rowley, A. H. & Shulman, S. T. Nationwide survey of Kawasaki disease and acute rheumatic fever. J. Pediatr. 119, 279–282 (1991). - DOI
1. Taubert, K. A. Epidemiology of Kawasaki disease in the United States and worldwide. Prog. Pediatr. Cardiol. 6, 181–185 (1997). - DOI
1. Holman, R. C. et al. Kawasaki syndrome hospitalizations in the United States, 1997 and 2000. Pediatrics 112, 495–501 (2003). - DOI
1. Makino, N. et al. Nationwide epidemiologic survey of Kawasaki disease in Japan, 2015-2016. Pediatr. Int J. Jpn Pediatr. Soc. 61, 397–403 (2019).

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

CIHR/Canada

LinkOut - more resources

Full Text Sources
- Nature Publishing Group
Other Literature Sources
- scite Smart Citations
Medical
- MedlinePlus Health Information

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Incidence and short-term outcomes of Kawasaki disease

Affiliations

Incidence and short-term outcomes of Kawasaki disease

Authors

Affiliations

Abstract

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical