A novel model for predicting intravenous immunoglobulin-resistance in Kawasaki disease: a large cohort study
BackgroundPredicting intravenous immunoglobulin (IVIG)-resistant Kawasaki disease (KD) can aid early treatment and prevent coronary artery lesions. A clinically consistent predictive model was developed for IVIG resistance in KD.MethodsIn this retrospective cohort study of children diagnosed with KD...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-07-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1226592/full |
| _version_ | 1797770311049936896 |
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| author | Shuhui Wang Shuhui Wang Chuxin Ding Qiyue Zhang Miao Hou Ye Chen Hongbiao Huang Guanghui Qian Daoping Yang Changqing Tang Yiming Zheng Li Huang Lei Xu Jiaying Zhang Yang Gao Wenyu Zhuo Bihe Zeng Haitao Lv Haitao Lv |
| author_facet | Shuhui Wang Shuhui Wang Chuxin Ding Qiyue Zhang Miao Hou Ye Chen Hongbiao Huang Guanghui Qian Daoping Yang Changqing Tang Yiming Zheng Li Huang Lei Xu Jiaying Zhang Yang Gao Wenyu Zhuo Bihe Zeng Haitao Lv Haitao Lv |
| author_sort | Shuhui Wang |
| collection | DOAJ |
| description | BackgroundPredicting intravenous immunoglobulin (IVIG)-resistant Kawasaki disease (KD) can aid early treatment and prevent coronary artery lesions. A clinically consistent predictive model was developed for IVIG resistance in KD.MethodsIn this retrospective cohort study of children diagnosed with KD from January 1, 2016 to December 31, 2021, a scoring system was constructed. A prospective model validation was performed using the dataset of children with KD diagnosed from January 1 to June 2022. The least absolute shrinkage and selection operator (LASSO) regression analysis optimally selected baseline variables. Multivariate logistic regression incorporated predictors from the LASSO regression analysis to construct the model. Using selected variables, a nomogram was developed. The calibration plot, area under the receiver operating characteristic curve (AUC), and clinical impact curve (CIC) were used to evaluate model performance.ResultsOf 1975, 1,259 children (1,177 IVIG-sensitive and 82 IVIG-resistant KD) were included in the training set. Lymphocyte percentage; C-reactive protein/albumin ratio (CAR); and aspartate aminotransferase, sodium, and total bilirubin levels, were risk factors for IVIG resistance. The training set AUC was 0.825 (sensitivity, 0.723; specificity, 0.744). CIC indicated good clinical application of the nomogram.ConclusionThe nomogram can well predict IVIG resistance in KD. CAR was an important marker in predicting IVIG resistance in Kawasaki disease. |
| first_indexed | 2024-03-12T21:20:31Z |
| format | Article |
| id | doaj.art-1f34ae48bc5d4ff7a260a351ef135587 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-03-12T21:20:31Z |
| publishDate | 2023-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-1f34ae48bc5d4ff7a260a351ef1355872023-07-28T18:05:43ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2023-07-011010.3389/fcvm.2023.12265921226592A novel model for predicting intravenous immunoglobulin-resistance in Kawasaki disease: a large cohort studyShuhui Wang0Shuhui Wang1Chuxin Ding2Qiyue Zhang3Miao Hou4Ye Chen5Hongbiao Huang6Guanghui Qian7Daoping Yang8Changqing Tang9Yiming Zheng10Li Huang11Lei Xu12Jiaying Zhang13Yang Gao14Wenyu Zhuo15Bihe Zeng16Haitao Lv17Haitao Lv18Department of Cardiology, Children’s Hospital of Soochow University, Suzhou, ChinaDepartment of Pediatrics, Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, ChinaDepartment of Cardiology, Children’s Hospital of Soochow University, Suzhou, ChinaDepartment of Cardiology, Children’s Hospital of Soochow University, Suzhou, ChinaDepartment of Cardiology, Children’s Hospital of Soochow University, Suzhou, ChinaDepartment of Cardiology, Children’s Hospital of Soochow University, Suzhou, ChinaDepartment of Pediatrics, Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, ChinaDepartment of Pediatrics, Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, ChinaDepartment of Cardiology, Children’s Hospital of Soochow University, Suzhou, ChinaDepartment of Cardiology, Children’s Hospital of Soochow University, Suzhou, ChinaDepartment of Pediatrics, Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, ChinaDepartment of Pediatrics, Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, ChinaDepartment of Pediatrics, Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, ChinaDepartment of Pediatrics, Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, ChinaDepartment of Cardiology, Children’s Hospital of Soochow University, Suzhou, ChinaDepartment of Pediatrics, Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, ChinaDepartment of Pediatrics, Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, ChinaDepartment of Cardiology, Children’s Hospital of Soochow University, Suzhou, ChinaDepartment of Pediatrics, Institute of Pediatric Research, Children's Hospital of Soochow University, Suzhou, ChinaBackgroundPredicting intravenous immunoglobulin (IVIG)-resistant Kawasaki disease (KD) can aid early treatment and prevent coronary artery lesions. A clinically consistent predictive model was developed for IVIG resistance in KD.MethodsIn this retrospective cohort study of children diagnosed with KD from January 1, 2016 to December 31, 2021, a scoring system was constructed. A prospective model validation was performed using the dataset of children with KD diagnosed from January 1 to June 2022. The least absolute shrinkage and selection operator (LASSO) regression analysis optimally selected baseline variables. Multivariate logistic regression incorporated predictors from the LASSO regression analysis to construct the model. Using selected variables, a nomogram was developed. The calibration plot, area under the receiver operating characteristic curve (AUC), and clinical impact curve (CIC) were used to evaluate model performance.ResultsOf 1975, 1,259 children (1,177 IVIG-sensitive and 82 IVIG-resistant KD) were included in the training set. Lymphocyte percentage; C-reactive protein/albumin ratio (CAR); and aspartate aminotransferase, sodium, and total bilirubin levels, were risk factors for IVIG resistance. The training set AUC was 0.825 (sensitivity, 0.723; specificity, 0.744). CIC indicated good clinical application of the nomogram.ConclusionThe nomogram can well predict IVIG resistance in KD. CAR was an important marker in predicting IVIG resistance in Kawasaki disease.https://www.frontiersin.org/articles/10.3389/fcvm.2023.1226592/fullKawasaki diseaseintravenous immunoglobulin resistanceprediction modelC-reactive protein to albumin ratio (CAR)children |
| spellingShingle | Shuhui Wang Shuhui Wang Chuxin Ding Qiyue Zhang Miao Hou Ye Chen Hongbiao Huang Guanghui Qian Daoping Yang Changqing Tang Yiming Zheng Li Huang Lei Xu Jiaying Zhang Yang Gao Wenyu Zhuo Bihe Zeng Haitao Lv Haitao Lv A novel model for predicting intravenous immunoglobulin-resistance in Kawasaki disease: a large cohort study Frontiers in Cardiovascular Medicine Kawasaki disease intravenous immunoglobulin resistance prediction model C-reactive protein to albumin ratio (CAR) children |
| title | A novel model for predicting intravenous immunoglobulin-resistance in Kawasaki disease: a large cohort study |
| title_full | A novel model for predicting intravenous immunoglobulin-resistance in Kawasaki disease: a large cohort study |
| title_fullStr | A novel model for predicting intravenous immunoglobulin-resistance in Kawasaki disease: a large cohort study |
| title_full_unstemmed | A novel model for predicting intravenous immunoglobulin-resistance in Kawasaki disease: a large cohort study |
| title_short | A novel model for predicting intravenous immunoglobulin-resistance in Kawasaki disease: a large cohort study |
| title_sort | novel model for predicting intravenous immunoglobulin resistance in kawasaki disease a large cohort study |
| topic | Kawasaki disease intravenous immunoglobulin resistance prediction model C-reactive protein to albumin ratio (CAR) children |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1226592/full |
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