Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-24T07:42:57.406Z Has data issue: false hasContentIssue false

An update on the epidemiology, length of stay, and cost of Kawasaki disease hospitalisation in the United States

Published online by Cambridge University Press:  06 June 2019

Laxmi V. Ghimire*
Affiliation:
Section of Pediatrics and Section of Cardiology, Department of Medicine, Lakes Region General Hospital, Laconia, NH, USA Department of Pediatrics, University of New England Biddeford, ME, USA
Fu-Sheng Chou
Affiliation:
Division of Neonatology, Children’s Mercy Hospital, Kansas City, MO, USA Department of Pediatrics, University of Missouri-Kansas City, Kansas City, MO, USA Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, USA
Narayan B. Mahotra
Affiliation:
Department of Clinical Physiology, Tribhuvan University, Institute of Medicine, Kathmandu, Nepal
Sharan P. Sharma
Affiliation:
Department of Medicine, Lakes Region General Hospital, Laconia, NH, USA
*
Author for correspondence: Laxmi V. Ghimire, MD, Section of Pediatrics and Section of Cardiology, Lakes Region General Hospital, Laconia, NH 03246, USA. Tel: +603 528-0995; Email: [email protected]

Abstract

Background:

Kawasaki disease is an acute vasculitis of childhood and is the leading cause of acquired heart disease in the developed countries.

Methods:

Data from hospital discharge records were obtained from the National Kids Inpatient Database for years 2009 and 2012. Hospitalisations by months, hospital regions, timing of admission, insurance types, and ethnicity were analysed. Length of stay and total charges were also analysed.

Results:

There were 10,486 cases of Kawasaki disease from 12,678,005 children hospitalisation. Kawasaki disease was more common between 0 and 5 years old, in male, and in Asian. The January–March quarter had the highest rate compared to the lowest in the July–September quarter (OR=1.62, p < 0.001). Admissions on the weekend had longer length of stay [4.1 days (95 % CI: 3.97–4.31)] as compared to admissions on a weekday [3.72 days (95 % CI: 3.64–3.80), p < 0.001]. Blacks had the longest length of stay and whites had the shortest [4.33 days (95 % CI: 4.12–4.54 days) versus 3.60 days (95 % CI: 3.48–3.72 days), p < 0.001]. Coronary artery aneurysm was identified in 2.7 % of all patients with Kawasaki disease. Children with coronary artery aneurysm were hospitalised longer and had higher hospital charge. Age, admission during weekend, and the presence of coronary artery aneurysm had significant effect on the length of stay.

Conclusions:

This report provides the most updated epidemiological information on Kawasaki disease hospitalisation. Age, admissions during weekend, and the presence of coronary artery aneurysm are significant contributors to the length of stay.

Type
Original Article
Copyright
© Cambridge University Press 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Dajani, AS, Taubert, KA, Gerber, MA, et al. Diagnosis and therapy of Kawasaki disease in children. Circulation 1993; 87: 17761780.CrossRefGoogle ScholarPubMed
Kato, H, Sugimura, T, Akagi, T, et al. Long-term consequences of Kawasaki disease. A 10- to 21-year follow-up study of 594 patients. Circulation 1996; 94: 13791385.CrossRefGoogle ScholarPubMed
McCrindle, BW, Rowley, AH, Newburger, JW, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a scientific statement for health professionals from the American Heart Association. Circulation 2017; 135: e927e999.CrossRefGoogle ScholarPubMed
Uehara, R, Belay, ED. Epidemiology of Kawasaki disease in Asia, Europe, and the United States. J Epidemiol 2012; 22: 7985.CrossRefGoogle ScholarPubMed
Burns, JC, Herzog, L, Fabri, O, et al. Seasonality of Kawasaki disease: a global perspective. PLoS One 2013; 8: e74529.CrossRefGoogle ScholarPubMed
Holman, RC, Curns, AT, Belay, ED, Steiner, CA, Schonberger, LB. Kawasaki syndrome hospitalizations in the United States, 1997 and 2000. Pediatrics 2003; 112: 495501.CrossRefGoogle ScholarPubMed
Okubo, Y, Nochioka, K, Sakakibara, H, Testa, M, Sundel, RP. National survey of pediatric hospitalizations due to Kawasaki disease and coronary artery aneurysms in the USA. Clin Rheumatol 2017; 36: 413419.CrossRefGoogle ScholarPubMed
Kitano, N, Suzuki, H, Takeuchi, T. Patient age and the seasonal pattern of onset of Kawasaki’s disease. N Engl J Med 2018; 378: 20482049.CrossRefGoogle Scholar
Onouchi, Y. Genetics of Kawasaki disease. Circ J 2012; 76: 15811586.CrossRefGoogle ScholarPubMed
Belay, ED, Maddox, RA, Holman, RC, et al. Kawasaki syndrome and risk factors for coronary artery abnormalities: United States, 1994-2003. Pediatr Infect Dis J 2006; 25: 245249.CrossRefGoogle ScholarPubMed
Callinan, LS, Tabnak, F, Holman, RC, et al. Kawasaki syndrome and factors associated with coronary artery abnormalities in California. Pediatr Infect Dis J 2012; 31: 894898.CrossRefGoogle ScholarPubMed
The Henry J. Kaiser Family Foundation. Key facts on health and health care by race and ethnicity – section 4: health coverage. 2016. Available at: https://www.kff.org/report-section/key-facts-on-health-and-health-care-by-race-and-ethnicity-section-4-health-coverage/. (Accessed: 23rd February 2019).Google Scholar