Presentation Information
[III-PSY4-5]Current Epidemiology of Severe Cardiovascular Sequelae in Adults After Kawasaki Disease in Japan: JROAD-DPC study
○Yoshihide Mitani1, Michikazu Nakai2, Etsuko Tsuda3 (1.Perinatal Care Center, Mie University Hospital, Mie University Hospital, MieUniversity Graduate School of Medicine, Japan, 2.Clinical Resarch Support Center, University of Miyazaki Hospital, 3.Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center,)
Keywords:
川崎病,移行期医療,Big data
Background: Kawasaki disease (KD) leads to coronary artery lesions (CAL), increasing the risk of cardiovascular events (CVE). Epidemiology and prognostic factors for adults hospitalized with KD-related CVE are poorly defined. Hypothesis: Disrupted continuity of medical care increases the risk of adverse outcomes in adults hospitalized for CAL of KD. Methods:A retrospective nationwide cohort study analyzed 798 adults (≧15 years) hospitalized for KD-related cardiovascular conditions from April 2013 to March 2022 (JROAD-DPC). Primary and secondary outcomes were in-hospital mortality and ICU admission. Multivariable logistic regression assessed associations with emergency and non-referral admissions. Results: Of 798 patients (74.4% male, median age 37 [IQR:23－46]), diagnoses included acute coronary syndrome (19.7%), percutaneous coronary intervention (13.0%), coronary artery bypass grafting (14.2%), and heart failure/arrhythmia (53.1%). Age showed bimodal distribution: ＜20 years and 35－39 years. Overall, emergency admissions were 33.0%, non-referral admissions 16.0%, ICU admissions 27.6%, and mortality 1.3%. Multivariable analysis identified emergency admission (OR 8.49; 95%CI, 1.80－40.04; P=.007) and non-referral admission (OR 6.69; 95%CI, 1.68－26.60; P=.007) as independent predictors of mortality. Conclusions: Adults hospitalized for KD-related CVE are predominantly young, non-obese males, with emergency/non-referral admissions significantly associated with poorer outcomes. Structured transition-of-care programs and enhanced adult cardiology awareness are crucial.