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. 2023 Sep 1;62(9):3117-3125.
doi: 10.1093/rheumatology/kead051.

The incidence of Kawasaki disease using hospital admissions data for England 2006-2021

Myron Odingo  1   2 , Megan Rutter  1   2   3 , Jonathan Bowley  1 , Emily J Peach  1 , Peter C Lanyon  1   2   3 , Matthew J Grainge  1 , Peter Stillwell  2 , Sean McPhail  2 , Mary Bythell  2 , Jeanette Aston  2 , Sarah Stevens  2 , Rachael McCormack  4 , Paul Brogan  5 , Fiona A Pearce  1   2   3
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The incidence of Kawasaki disease using hospital admissions data for England 2006-2021

Myron Odingo et al. Rheumatology (Oxford). .

Abstract

Objective: To describe the incidence of Kawasaki Disease (kDa) between 2006 and 2021 in England.

Methods: We identified all cases in hospital episode statistics with an ICD-10 diagnostic code M303 (for kDa) between 1 April 2006 and 31 March 2021. We validated 83 diagnoses using hospital medical records and found >97% accuracy. We calculated incidence rate ratios (IRRs) using Poisson regression and assessed the influence of age, sex, ethnicity and index of multiple deprivation (IMD). We used Office for National Statistics population estimates for England as the denominator.

Results: We identified a total of 5908 cases of kDa in all children under the age of 16 (mean age 3.8, s.d.=3.2, 95% CI: 3.7, 3.9). Incidence in children aged <5 years was 8.9 (95% CI: 8.6, 9.2)/100 000 person-years; in children aged 5-9, 2.4 (95% CI: 2.3, 2.6)/100 000 person-years; and in children aged 10-15, 0.6 (95% CI: 0.6, 0.7). Male : female ratio was 1.5 : 1. Incidence was higher among non-White than White ethnicities [adjusted IRR 2.1 (2.0-2.2) for Asian, 3.0 (2.8-3.3) for Black and 4.5 (4.2-4.8) for other ethnicities]. The incidence increased with socioeconomic deprivation; the adjusted IRR of the least deprived IMD quintile compared with the most deprived quintile was 0.81 (0.77-0.84).

Conclusions: Incidence rates of kDa derived from hospital admission data in England were higher than in studies relying on clinician reporting. We confirm previous findings on the influence of sex and ethnicity on kDa incidence and observe that there was a higher incidence of kDa within more deprived socioeconomic groups.

Keywords: Kawasaki disease; cardiovascular; epidemiology; paediatric; vasculitis.

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Figures

Figure 1.
Figure 1.
Annual incidence of Kawasaki disease at age <5, 5–9 and 10–15. *Error bars show 95% CI for incidence rates
Figure 2.
Figure 2.
Kawasaki disease incidence age <16 years (i) by month and year and (ii) by month (2006–2021 combined). (A) The frequency of KD incident cases by month and year; (B) the frequency of KD incidence cases by month
Figure 3.
Figure 3.
Choropleth map showing Kawasaki disease rates by region (rates per 100 000 patient-years). Colour version available online
See this image and copyright information in PMC

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