VALUE OF DOMESTIC CONSENSUS VERSUS AHA STATEMENT IN DIAGNOSIS OF KAWASAKI DISEASE

Abstract

Objective To investigate the value of The Expert Consensus on Diagnosis and Acute-phase Treatment of Kawasaki Disease (hereinafter referred to as domestic consensus) versus the 2017 edition of Diagnosis, Treatment, and Long-term Management of Kawasaki Disease: A Scientific Statement for Health Professionals from the American Heart Association (hereinafter referred to as AHA statement) in the diagnosis of Kawasaki disease (KD). Methods A retrospective analysis was performed for the clinical data of 650 children who were preliminarily diagnosed with KD in Heart Center of Women and Children’s Hospital Affiliated of Qingdao University from November 2016 to March 2021, and the 650 children were diagnosed based on clinical manifestations, laboratory examination, echocardiography, and final follow-up results (with the exclusion of other systemic diseases during follow-up), which were considered the actual confirmed diagnosis. In addition, the 650 children were also diagnosed accor-ding to the domestic consensus and the AHA statement. All children were divided into KD group and non-KD group according to the three diagnostic results, and the KD group was further divided into complete KD group and incomplete KD group. At the same time, the 650 children were divided into ≥6 months group and <6 months group based on age, and each age group was further grouped according to the above method. The two sets of diagnostic criteria were analyzed in terms of diagnostic sensitivity, specifi-city, accuracy, false positive rate, false negative rate, positive predictive value, and negative predictive value. Results In the diagnosis of KD and complete KD, there was a significant difference in diagnostic sensitivity between the two sets of diagnostic criteria (P<0.05). In the diagnosis of incomplete KD, there were significant differences in sensitivity, specificity, and Youden index between the two sets of diagnostic criteria (U=2.285,P<0.05). In the diagnosis of KD in children aged ≥6 months, there was a significant difference in sensitivity between the two sets of diagnostic criteria (P<0.05). Conclusion The domestic consensus is better than the AHA statement in diagnosis and significantly improves the diagnostic sensitivity of incomplete KD in children, and thus it is more suitable for the diagnosis of incomplete KD in Chinese children. However, the domestic consensus should be further improved in terms of its specificity in the diagnosis of KD in children aged <6 months.

Keywords

• mucocutaneous lymph node syndrome|diagnosis|sensitivity and specificity|reference standards|child