Ten-year Audit of Kawasaki Disease in a District General Hospital

Abstract

Background: This audit aimed to evaluate the cases Kawasaki disease (KD) seen in the pediatric department of a community hospital over a 10-year-period. In particular, length of time to diagnosis and variations in treatment were reviewed. Possible effects of these factors on patient outcome in the acute and chronic phase of KD were analyzed. Methods: Data were obtained from the hospital information and coding departments. The following parameters were studied: demographic characteristics, presenting signs and symptoms, duration and peak of fever, hemoglobin and platelet count, coagulation times, C-reactive protein, urine dipstick analysis, length of hospital admission and cardiovascular abnormalities. The data were compared using standard computer software. Results: Eleven patients were identified. Seven of them were male, and the mean age was 35 months. Mean length of hospital stay was 5 days. Mean time from admission to diagnosis was 4 days. All but one patient were given one course of immunoglobulin upon diagnosis. Two developed coronary artery aneurysms and were still receiving aspirin therapy at the time of the audit. Eight of the 11 patients were treated with antibiotics during their time in hospital, all prescribed to treat suspected infections. Once KD had been confirmed antibiotics were stopped. Conclusion: A retrospective case note audit was performed which found that delay in diagnosis may be associated with cardiac complications. The data analyzed highlight the importance of early diagnosis and adequate treatment of KD. It is likely that new genetic tests will help clinicians achieve these goals in the near future.