講演情報
[III-PSY4-5]成人期川崎病の重症心血管後遺症の日本の疫学：JROAD-DPC研究
○三谷 義英1, 中井 陸運2, 津田 悦子3 (1.三重大学医学部附属病院周産母子センター, 2.宮崎大学病院臨床研究支援センター, 3.国立循環器病研究センター小児循環器内科)
キーワード：
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.