Table 1. Patient Characteristics and Clinical Outcomes According to Immunomodulatory Treatments Received at Any Time during Hospitalization.*.
| Variable | Any Treatment (N=518) |
IVIG Only (N=89) |
IVIG and Glucocorticoids (N=241) |
IVIG, Glucocorticoids, and a Biologic (N=107) |
Other Treatments† (N=81) |
|---|---|---|---|---|---|
| Demographic characteristics | |||||
| Male sex — no. (%) | 301 (58) | 49 (55) | 135 (56) | 65 (61) | 52 (64) |
| Age — yr | |||||
| Median (IQR) | 8.7 (4.9–12.8) | 5.5 (2.5–10.5) | 8.6 (4.6–12.0) | 9.0 (5.9–13.5) | 10.5 (5.9–15.0) |
| Range | 0–20.9 | 0.1–19.1 | 0–20.8 | 0–19.3 | 0.9–20.9 |
| Race and ethnic group — no. (%)‡ | |||||
| White, non-Hispanic | 69 (13) | 12 (13) | 31 (13) | 15 (14) | 11 (14) |
| Black, non-Hispanic | 183 (35) | 27 (30) | 94 (39) | 41 (38) | 21 (26) |
| Hispanic or Latino | 174 (34) | 27 (30) | 80 (33) | 39 (36) | 28 (35) |
| Asian | 19 (4) | 4 (4) | 9 (4) | 2 (2) | 4 (5) |
| Other race, non-Hispanic | 28 (5) | 3 (3) | 14 (6) | 6 (6) | 5 (6) |
| Unknown | 72 (14) | 22 (25) | 25 (10) | 8 (7) | 17 (21) |
| Preexisting conditions | |||||
| At least one coexisting condition, excluding obesity — no. (%) | 128 (25) | 21 (24) | 48 (20) | 23 (21) | 36 (44) |
| Respiratory condition — no. (%) | 67 (13) | 14 (16) | 24 (10) | 9 (8) | 20 (25) |
| Cardiovascular condition — no. (%) | 14 (3) | 2 (2) | 3 (1) | 4 (4) | 5 (6) |
| Other preexisting condition — no. (%)§ | 47 (9) | 7 (8) | 13 (5) | 11 (10) | 16 (20) |
| Clinically diagnosed obesity — no./total no. (%)¶ | 40/459 (9) | 4/72 (6) | 19/212 (9) | 5/98 (5) | 12/77 (16) |
| Clinical and cardiac characteristics | |||||
| Involvement of at least five organ systems — no. (%) | 286 (55) | 30 (34) | 139 (58) | 81 (76) | 36 (44) |
| Criteria for Kawasaki’s disease — no. (%)‖ | 196 (38) | 45 (51) | 91 (38) | 43 (40) | 17 (21) |
| Troponin level on admission | |||||
| No. of patients | 261 | 30 | 134 | 59 | 38 |
| Median (IQR) — ng/ml | 0.11 (0.02–0.74) | 0.15 (0.02–7.50) | 0.08 (0.02–0.56) | 0.12 (0.04–0.70) | 0.12 (0.02–3.60) |
| B-type natriuretic peptide level on admission | |||||
| No. of patients | 194 | 18 | 114 | 32 | 30 |
| Median (IQR) — pg/ml | 404.0 (87.1–1062.9) | 147.0 (50.7–333.3) | 483.6 (103.0–1062.9) | 833.0 (182.0–2698.4) | 375.0 (81.3–504.8) |
| N-terminal pro–B-type natriuretic peptide level on admission | |||||
| No. of patients | 122 | 18 | 53 | 42 | 9 |
| Median (IQR) — pg/ml | 1292.5 (227.8–3700.8) | 1475.0 (220.2–2121.8) | 604.0 (137.0–1921.0) | 2024.5 (433.5–7799.2) | 2900.0 (630.0–4633.0) |
| LVEF <55% during hospitalization — no. (%) | 212 (41) | 25 (28) | 99 (41) | 62 (58) | 26 (32) |
| Coronary-artery aneurysm — no. (%)** | 64 (12) | 4 (4) | 32 (13) | 22 (21) | 6 (7) |
| Interventions and hospital course | |||||
| ICU admission — no. (%) | 385 (74) | 43 (48) | 185 (77) | 95 (89) | 62 (77) |
| Supplemental oxygen — no. (%) | 287 (55) | 26 (29) | 133 (55) | 76 (71) | 52 (64) |
| Mechanical ventilation — no. (%) | 91 (18) | 7 (8) | 25 (10) | 42 (39) | 17 (21) |
| Vasopressors — no. (%) | 245 (47) | 23 (26) | 110 (46) | 77 (72) | 35 (43) |
| Extracorporeal membrane oxygenation — no. (%) | 16 (3) | 1 (1) | 1 (<1) | 10 (9) | 4 (5) |
| Discharged alive — no. (%) | 509 (98) | 88 (99) | 241 (100) | 104 (97) | 76 (94) |
| Median hospital length of stay among survivors (IQR) — days | 7 (4–10) | 5 (4–7) | 7 (5–9) | 12 (8–17) | 6 (4–9) |
| Died — no. (%) | 9 (2) | 1 (1) | 0 | 3 (3) | 5 (6) |
Among the 518 patients, the percentages of patients corresponding to the numbers of patients in each treatment category were as follows: 17% received intravenous immune globulin (IVIG) only; 47% received IVIG and glucocorticoids; 21% received IVIG, glucocorticoids, and a biologic; and 16% received other treatments. ICU denotes intensive care unit, IQR interquartile range, and LVEF left ventricular ejection fraction.
Other treatments included glucocorticoids only (40 patients), a biologic only (7 patients), IVIG and a biologic (24 patients), and glucocorticoids and a biologic (10 patients).
Information on race and ethnic group was collected from hospital medical records or was reported by the patient, parent, or caregiver to the site clinicians caring for the patients. Race categories are not mutually exclusive.
Other preexisting conditions include neurologic or neuromuscular, oncologic, immunosuppressive, autoimmune, hematologic, renal, urologic, gastrointestinal, hepatic, endocrine, genetic, and metabolic disorders.
The determination of clinically diagnosed obesity was based on reporting by clinicians among patients who were at least 2 years of age. The denominators include all patients who were at least 2 years of age at the time of admission.
This category includes patients who met complete or incomplete criteria for Kawasaki’s disease as defined by American Heart Association guidelines.7
Coronary-artery aneurysm was defined as a z score of at least 2.5 for the left anterior descending coronary artery or the right coronary artery (or both) on echocardiography.