A novel model for predicting intravenous immunoglobulin-resistance in Kawasaki disease: a large cohort study

Frontiers in Cardiovascular Medicine

Cardiovascular Medicine

Miao Hou¹  Changqing Tang¹  Chuxin Ding¹  Ye Chen¹  Daoping Yang¹  Qiyue Zhang¹  Yang Gao¹  Shuhui Wang²  Haitao Lv²  Yiming Zheng³  Lei Xu³  Bihe Zeng³  Li Huang³  Hongbiao Huang³  Jiaying Zhang³  Guanghui Qian³  Wenyu Zhuo³ 

[1] Department of Cardiology, Children’s Hospital of Soochow University, Suzhou, China;Department of Cardiology, Children’s Hospital of Soochow University, Suzhou, China;Department of Pediatrics, Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, China;Department of Pediatrics, Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, China;

关键词: Kawasaki disease;    intravenous immunoglobulin resistance;    prediction model;    C-reactive protein to albumin ratio (CAR);    children;   

DOI  :  10.3389/fcvm.2023.1226592

 received in 2023-05-21, accepted in 2023-07-13,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundPredicting intravenous immunoglobulin (IVIG)-resistant Kawasaki disease (KD) can aid early treatment and prevent coronary artery lesions. A clinically consistent predictive model was developed for IVIG resistance in KD.MethodsIn this retrospective cohort study of children diagnosed with KD from January 1, 2016 to December 31, 2021, a scoring system was constructed. A prospective model validation was performed using the dataset of children with KD diagnosed from January 1 to June 2022. The least absolute shrinkage and selection operator (LASSO) regression analysis optimally selected baseline variables. Multivariate logistic regression incorporated predictors from the LASSO regression analysis to construct the model. Using selected variables, a nomogram was developed. The calibration plot, area under the receiver operating characteristic curve (AUC), and clinical impact curve (CIC) were used to evaluate model performance.ResultsOf 1975, 1,259 children (1,177 IVIG-sensitive and 82 IVIG-resistant KD) were included in the training set. Lymphocyte percentage; C-reactive protein/albumin ratio (CAR); and aspartate aminotransferase, sodium, and total bilirubin levels, were risk factors for IVIG resistance. The training set AUC was 0.825 (sensitivity, 0.723; specificity, 0.744). CIC indicated good clinical application of the nomogram.ConclusionThe nomogram can well predict IVIG resistance in KD. CAR was an important marker in predicting IVIG resistance in Kawasaki disease.

【 授权许可】

Unknown   
© 2023 Wang, Ding, Zhang, Hou, Chen, Huang, Qian, Yang, Tang, Zheng, Huang, Xu, Zhang, Gao, Zhuo, Zeng and Lv.