Grasa et al reported risk scores based on the KAWA-RACE cohort. One risk score predicts the risk of being unresponsive to intravenous immunoglobulin (IVIG). The authors are from multiple institutions in Spain.
Patient selection: Kawasaki disease
Parameters:
(1) gender
(2) age at admission
(3) days of fever
(4) lymphadenopathy
(5) serum creatinine in mg/dL
(6) serum C-reactive protein (CRP) in mg/dL
(7) hemoglobin in g/dL
(8) serum sodium in mmol/L
(9) cardiologic abnormality
Parameters
Finding
Points
gender
female
0
male
1.6
age at admission
< 3 months
1.6
>= 3 months
0
days of fever
< 8 days
0
>= 8 days
7.6
lymphadenopathy
no
0
yes
1.3
serum creatinine
< 0.4 mg/dL
0
>= 0.4 mg/dL
3.4
serum CRP
< 8.7 mg/dL
0
>= 8.7 mg/dL
3.7
hemoglobin
< 10 g/dL
2.3
>= 10 g/dL
0
serum sodium
< 134 mmol/L
2.4
>= 134 mmol/L
0
cardiac abnormality
no
0
yes
1.2
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 25.1
• A score >= 8 is associated with IVIG unresponsiveness.
A line approximating Figure 4:
Score
0 to 5
(0.34 * (score)) + 0.68
5 to 10
(1.36 * (score)) - 4.42
10 to 25.1
(5.478 * (score)) - 47.91
Performance:
• The area under the ROC curve was 0.83 on the derivation but 0.73 on the external cohorts.
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