Characteristics of admissions for Kawasaki Disease from 1997 to 2012: Lessons from a national database

Abstract

AbstractA majority of large epidemiologic studies on Kawasaki Disease have come from Asia. There is paucity of data assessing Kawasaki Disease on a national level in the U.S., particularly in terms of hospitalization co-morbidities and cost. This study set forth to analyze data from the Kids’ Inpatient Database from 1997 to 2012. Data were analyzed for age, race, cardiogenic shock, acute kidney injury, liver failure, acute respiratory distress syndrome, arrhythmia, and congenital heart disease. Additionally, multivariate regression analysis was performed to assess the impact of Kawasaki Disease on coronary artery aneurysms, ECMO, length of stay, cost of stay, and mortality. Asian and Pacific Islander children were disproportionally affected by Kawasaki Disease in the U.S (20.8% of Kawasaki Disease admissions vs 3.3% of all other pediatric hospital admissions, p<0.01). Patients hospitalized for Kawasaki Disease had an increased risk of developing coronary artery aneurysms (OR 2,839, 95%CI 2,2985-3,527) and cardiogenic shock (OR 3.42, 95% CI 2.18-5.37). Patients with Kawasaki disease were less likely to have congenital heart disease (OR 0.62, 95%CI 0.55-0.69), arrhythmia (OR 0.31, 95%CI 0.11-0.84), and acute respiratory distress syndrome (OR 0.29, 95%CI 0.19-0.43). Kawasaki disease patients had shorter hospitalization length of stay by 2.59 days (p <0.01) and decreased cost of stay by $5,513 (p <0.01). Kawasaki Disease had lower mortality when compared to all other admissions (OR 0.03, 95%CI 0.01-0.09). No significant differences were found for ECMO, acute kidney injury, or liver failure.