Original ArticleIncreased Detection Rate of Kawasaki Disease Using New Diagnostic Algorithm, Including Early Use of Echocardiography
Section snippets
Methods
We conducted a descriptive, prospective multicenter cohort study in a 1-year period (Sep 1, 2005-Aug 31, 2006) that involved all pediatric departments of the 18 hospitals in Northern France (1 million children <18 years old). All departments agreed to participate in this study. The local coordinating investigator at each center was a pediatrician belonging to the Hospital Network for Evaluating the Management of Common Childhood Diseases. Each patient <18 years old admitted for a prolonged but
Results
During the study period, 77 children met the inclusion criteria. Confirmed or uncertain KD was diagnosed in 39 children. The mean age of the population with KD was 37 months (range, 3-161 months), with 30 of these patients (77%) <5 years of age. The overall ethnic distribution was 69% Caucasian, 5% North African, 3% African, 0% Asian or American, and 23% unknown. The male- to-female ratio was 2.9. The mean length of fever was 6.3 days (median, 6; range, 3-15). Echocardiography was performed in
Discussion
Of the 39 patients identified prospectively as having confirmed or uncertain KD, 33 had confirmed KD, for an incidence of 9 in 100 000 children <5 years old. Seven of these 33 cases (21%) had incomplete KD, and all except 1 case were confirmed with echocardiographic abnormalities.
The failure to include incomplete KD may result in an underestimation of its incidence in Europe. Earlier reports from France, for example, estimated the incidence of KD at 5 in 100 000 children <5 years of age,9, 10
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A list of members of the Hospital Network for Evaluating the Management of Common Childhood Diseases is available at www.jpeds.com (Appendix). The authors declare no conflicts of interest.