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Sci Rep ; 9(1): 1722, 2019 02 11.
Article in English | MEDLINE | ID: mdl-30742060

ABSTRACT

Accurate evaluation of individual risk of intravenous immunoglobin (IVIG)-resistance is critical for adopting regimens for the first treatment and prevention of coronary artery lesions (CALs) in patients with Kawasaki disease (KD). METHODS: The KD patients hospitalized in Chongqing Children's Hospital, in west China, from October 2007 to December 2017 were retrospectively reviewed. Data were collected and compared between IVIG-resistant group and IVIG-responsive group. The independent risk factors were determined using multivariate regression analysis. A new prediction model was built and compared with the previous models. RESULTS: A total of 5277 subjects were studied and eight independent risk factors were identified including higher red blood cell distribution width (RDW), lower platelet count (PLT), lower percentage of lymphocyte (P-LYM), higher total bile acid (TBA), lower albumin, lower serum sodium level, higher degree of CALs (D-CALs) and younger age. The new predictive model showed an AUC of 0.74, sensitivity of 76% and specificity of 59%. For individual's risk probability of IVIG-resistance, an equation was given. CONCLUSIONS: IVIG-resistance could be predicted by RDW, PLT, P-LYM, TBA, albumin, serum sodium level, D-CALs and age. The new model appeared to be superior to those previous models for KD population in Chongqing city.


Subject(s)
Drug Resistance , Immunoglobulins, Intravenous/therapeutic use , Models, Theoretical , Mucocutaneous Lymph Node Syndrome/drug therapy , Mucocutaneous Lymph Node Syndrome/epidemiology , Biomarkers , China/epidemiology , Humans , Immunoglobulins, Intravenous/administration & dosage , Immunoglobulins, Intravenous/adverse effects , Mucocutaneous Lymph Node Syndrome/diagnosis , Odds Ratio , Prognosis , ROC Curve , Retrospective Studies , Severity of Illness Index , Treatment Outcome
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