Letter to the editor regarding “Value of C-reactive protein/albumin ratio in predicting intravenous immunoglobulin-resistant Kawasaki disease – A data from multi-institutional study in China”

2021 ◽  
pp. 107632
Author(s):  
Xiaoliang Liu ◽  
Kaiyu Zhou ◽  
Yimin Hua ◽  
Chuan Wang
2015 ◽  
Vol 100 (4) ◽  
pp. 366-368 ◽  
Author(s):  
Sarah Davies ◽  
Natalina Sutton ◽  
Sarah Blackstock ◽  
Stuart Gormley ◽  
Clive J Hoggart ◽  
...  

The Kobayashi score (KS) predicts intravenous immunoglobulin (IVIG) resistance in Japanese children with Kawasaki disease (KD) and has been used to select patients for early corticosteroid treatment. We tested the ability of the KS to predict IVIG resistance and coronary artery abnormalities (CAA) in 78 children treated for KD in our UK centre. 19/59 children were IVIG non-responsive. This was not predicted by a high KS (11/19 IVIG non-responders, compared with 26/40 responders, had a score ≥4; p=0.77). CAA were not predicted by KS (12/20 children with CAA vs 25/39 with normal echo had a score ≥4; p=0.78). Low albumin and haemoglobin, and high C-reactive protein were significantly associated with CAA. The KS does not predict IVIG resistance or CAA in our population. This highlights the need for biomarkers to identify children at increased risk of CAA, and to select patients for anti-inflammatory treatment in addition to IVIG.


2021 ◽  
Author(s):  
Zhenquan Wang ◽  
Yiping Shao ◽  
Xing Rong ◽  
Huixian Qiu ◽  
Jinxing Wang ◽  
...  

Abstract Objective: To investigate the association between the C-reactive protein/albumin ratio (CAR) and coronary artery lesions (CAL), intravenous immunoglobulin (IVIG) resistance in children with Kawasaki disease (KD).Methods: We retrospectively studied 753 children with KD, categorizing them into the CAL group(n=238) and the No-CAL group(n=515), the IVIG-resistance group(n=61) and the No-IVIG- resistance(n=653) group. The differences in laboratory data, clinical manifestations, the relationship between CAR and CAL as well as IVIG resistance were compared between the two cohort groups.Results: Compared with No-CAL group, KD with CAL had a higher CAR (2.12 vs 1.69, p <0.001). And CAR was significantly higher in KD children with IVIG resistance (2.42 vs 1.85, p<0.001). Multivariable logistic regression analysis demonstrated that higher CAR was a risk factors of CAL(OR=1.198, p<0.001) and IVIG resistance (OR=1.297, p<0.001), respectively. CAL and IVIG resistance interact with each other. ROC curve analysis performed for the prediction of CAL, the best cut-off point for CAR was 1.80(AUC=0.602, sensitivity 64.7%, specificity 54.8%). When predicting IVIG resistance according to the ROC curve analysis, the optimal cutoff point for CAR was 2.20(AUC=0.621, sensitivity 59.0%, specificity 61.1%).Conclusions: CAR is a valid indicator in KD children. Higher CAR may be helpful in predicting CAL and IVIG resistance in KD.


Angiology ◽  
2021 ◽  
pp. 000331972198919
Author(s):  
Sinan Cerşit ◽  
Lutfi Ocal ◽  
Muhammed Keskin ◽  
Mustafa Ozan Gürsoy ◽  
Macit Kalçik ◽  
...  

2019 ◽  
Vol 39 (11) ◽  
pp. 6283-6290 ◽  
Author(s):  
TERUHISA SAKAMOTO ◽  
YAKUKI YAGYU ◽  
EI UCHINAKA ◽  
MASAKI MORIMOTO ◽  
TAKEHIKO HANAKI ◽  
...  

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Runwen Liu ◽  
Yunqiang Cai ◽  
He Cai ◽  
Yajia Lan ◽  
Lingwei Meng ◽  
...  

Abstract Background With the recent emerge of dynamic prediction model on the use of diabetes, cardiovascular diseases and renal failure, and its advantage of providing timely predicted results according to the fluctuation of the condition of the patients, we aim to develop a dynamic prediction model with its corresponding risk assessment chart for clinically relevant postoperative pancreatic fistula after laparoscopic pancreaticoduodenectomy by combining baseline factors and postoperative time-relevant drainage fluid amylase level and C-reactive protein-to-albumin ratio. Methods We collected data of 251 patients undergoing LPD at West China Hospital of Sichuan University from January 2016 to April 2019. We extracted preoperative and intraoperative baseline factors and time-window of postoperative drainage fluid amylase and C-reactive protein-to-albumin ratio relevant to clinically relevant pancreatic fistula by performing univariate and multivariate analyses, developing a time-relevant logistic model with the evaluation of its discrimination ability. We also established a risk assessment chart in each time-point. Results The proportion of the patients who developed clinically relevant postoperative pancreatic fistula after laparoscopic pancreaticoduodenectomy was 7.6% (19/251); preoperative albumin and creatine levels, as well as drainage fluid amylase and C-reactive protein-to-albumin ratio on postoperative days 2, 3, and 5, were the independent risk factors for clinically relevant postoperative pancreatic fistula. The cut-off points of the prediction value of each time-relevant logistic model were 14.0% (sensitivity: 81.9%, specificity: 86.5%), 8.3% (sensitivity: 85.7%, specificity: 79.1%), and 7.4% (sensitivity: 76.9%, specificity: 85.9%) on postoperative days 2, 3, and 5, respectively, the area under the receiver operating characteristic curve was 0.866 (95% CI 0.737–0.996), 0.896 (95% CI 0.814–0.978), and 0.888 (95% CI 0.806–0.971), respectively. Conclusions The dynamic prediction model for clinically relevant postoperative pancreatic fistula has a good to very good discriminative ability and predictive accuracy. Patients whose predictive values were above 14.0%, 8.3%, and 7.5% on postoperative days 2, 3, and 5 would be very likely to develop clinically relevant postoperative pancreatic fistula after laparoscopic pancreaticoduodenectomy.


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