Background: Kawasaki disease (KD) is a major cause of childhood vasculitis and a common cause of acquired heart disease in children worldwide. This study sought to investigate the epidemiological characteristics of KD and to analyze the risk factors associated with KD complications, particularly coronary artery lesions (CALs). Methods: The medical records of children diagnosed with KD in Xuzhou from January 1, 2016, to December 31, 2020, were reviewed retrospectively. Categorical variables were analyzed using the Chi-square test, while unpaired Student's t-tests or the Mann–Whitney U test were employed for continuous data. Univariate and multivariable logistic regression analyses were conducted to identify risk factors of KD- associated CALs. Results: Of the 1082 children enrolled, the male-to-female ratio was 1.7:1. The age at diagnosis ranged from 1 to 127 months, with a median of 17 months. Seasonal variation was observed, with a peak incidence noted in summer (27.5%). CALs were identified in 292 cases (27.0%), detailed as follows: transient dilation (17.4%), mild dilation (4.0%), small aneurysms (2.9%), medium-sized aneurysms (1.9%), and giant aneurysms (0.8%). Independent risk factors for CALs included male gender, longer fever duration before intravenous immunoglobulin (IVIG), and elevated levels of leukocytes, C-reactive protein, creatine kinase-muscle/brain (CK-MB), and interleukin-6 (IL-6). Conclusions: Male gender, elevated levels of fever duration before IVIG, leukocytes, C-reactive protein, CK-MB, and IL-6 were predictive risk factors of CALs. These findings underscore the need for increased clinical awareness and targeted interventions to mitigate the risk of CALs in children affected by KD.
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