title: Epidemiologic features and prognostic factors of coronary artery lesions associated with Kawasaki disease based on a 13-year cohort of consecutive cases identified by complete enumeration surveys in Wakayama, Japan.
abstract: BACKGROUND
  To clarify the contribution of patient age to the development of coronary artery lesions (CALs) associated with Kawasaki disease (KD), epidemiologic features and prognostic factors were investigated using hospital-based complete enumeration surveys in a specific area.
  
  
  METHODS
  Consecutive KD cases identified between October 1999 and September 2012 in Wakayama Prefecture, Japan, were analyzed. The primary outcome measure was the presence/absence of CALs (giant aneurysm, mid- or small-sized aneurysm, and dilatation) on echocardiography 1 month after disease onset. Demographics and medical treatment factors were compared between the patients with and without CALs. Odds ratios (ORs) and 95% confidence intervals (CIs) of explanatory variables (age, gender, and factors related to high-dose intravenous immunoglobulin treatment) for the development of CALs were determined.
  
  
  RESULTS
  The median age of the 1415 patients (796 males, 619 females) was 25 months after excluding 2 children of foreign residents; 2.2% of the patients had a past history of KD, and 1.8% showed incomplete presentation. CALs were observed in 3.3% (4.0% of males, 2.3% of females; P = 0.080). The ORs of CALs among patients <11 months old (3.0, 95% CI 1.4-6.6) and those >48 months old (3.1, 95% CI 1.5-6.6) were significantly higher than values in 11- to 48-month-olds.
  
  
  CONCLUSIONS
  The effect of patient age on the development of CALs was found to be U-shaped, with the bottom at ages 11 to 48 months. This finding was based on a 13-year cohort of consecutive KD cases in a specific area with little selection bias and is consistent with previously reported results.
authors.affiliation: Department of Public Health, School of Medicine, Wakayama Medical University.
authors.forename: Naomi
authors.initials: N
authors.lastname: Kitano
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Suzuki
authors.forename: Takashi
authors.initials: T
authors.lastname: Takeuchi
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Suenaga
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Kakimoto
authors.forename: Shoichi
authors.initials: S
authors.lastname: Shibuta
authors.forename: Norishige
authors.initials: N
authors.lastname: Yoshikawa
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Takeshita
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications*; D011379:Prognosis; D012307:Risk Factors