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A novel model for predicting non‐responsiveness to intravenous immunoglobulins in Kawasaki disease: The Singapore experience
Author(s) -
Grignani Robert,
Rajgor Dimple D,
Leow YaoGuang,
Heng ChewKiat,
Quek SweeChye
Publication year - 2019
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.14329
Subject(s) - medicine , kawasaki disease , chinese population , scoring system , cohort , antibody , disease , population , pediatrics , immunology , biochemistry , chemistry , environmental health , artery , genotype , gene
Aim We aimed to assess the utility of four published risk‐scoring methods in predicting intravenous immunoglobulins (IVIG) non‐responsiveness in Kawasaki disease (KD) patients from Singapore and develop a new predictive model. Methods We reviewed the medical records of 215 KD children. The performance of existing scoring methods in identifying non‐responsive cases based on sensitivities (SN) and specificities (SP) was evaluated in 122 Singaporean Chinese. From our dataset, a model involving six predictors was built. Results The following respective SN (%) and SP (%) were obtained: Egami: 26%, 68%; Kobayashi: 21%, 62%; Sano: 13%, 86% and Fukunishi: 46%, 71%. These results indicated that the existing scoring methods performed poorly compared to those reported in their respective original publications, which ranged between 68 and 87%. The new predictive model was derived with an improved SN (80%) and SP (80%). Conclusions Currently available risk‐scoring methods have less applicability in the Singaporean Chinese population. The proposed new risk‐scoring predictive model derived based on data from Chinese cohort demonstrated much better SN and SP.