Predictive value of Albumin-Bilirubin grade for intravenous immunoglobulin resistance in a large cohort of patients with Kawasaki disease: a prospective study

Pediatric Rheumatology Online Journal

Nanjun Zhang¹  Kaiyu Zhou¹  Yimin Hua¹  Shuran Shao¹  Xiaoliang Liu¹  Chuan Wang¹  Lina Qiao¹  Lei Liu¹  Yu Yan¹  Mei Wu² 

[1] Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University;Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education;

关键词: Kawasaki disease;    albumin-bilirubin grade;    intravenous immunoglobulin resistance;   

DOI  :  10.1186/s12969-021-00638-7

来源: DOAJ

【 摘 要 】

Abstract Background Intravenous immunoglobulin (IVIG) resistance prediction is one of the primary clinical issues and study hotspots in KD. This study aimed to prospectively investigate the value of albumin-bilirubin grade (ALBI) in predicting IVIG resistance in KD and to assess whether ALBI has more predictive value or accuracy than either ALB or TBil alone in predicting IVIG resistance. Methods A total of 823 patients with KD were prospectively enrolled. The clinical and laboratory data were compared between the IVIG-response group (n = 708) and the IVIG-resistance group (n = 115). Multivariate logistic regression analysis was performed to identify the independent risk factors for IVIG resistance. Receiver operating characteristic (ROC) curves analysis was applied to assess the validity of ALBI, ALB, and TBil in predicting IVIG resistance. Results ALBI was significantly higher in patients with IVIG resistance and was identified as an independent risk factor for IVIG resistance in KD. The parameter of ALBI ≥ − 2.57 (AUC: 0.705, 95 %CI: 0.672–0.736), ALB ≤ 33.0 g/L (AUC: 0.659, 95 %CI: 0.626–0.692), and TBil ≥ 16.0µmol/L (AUC: 0.626, 95 %CI: 0.592–0.659), produced a sensitivity, specificity, PPV, and NPV of 0.617, 0.657, 0.226 and 0.914; 0.374, 0.850, 0.289 and 0.893; 0.269, 0.941, 0.425 and 0.888, respectively. Conclusions A higher ALBI was an independent risk factor for IVIG resistance in KD. It yielded better predictive ability than ALB and TBil alone for initial IVIG resistance.

【 授权许可】

Unknown