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Research article
Prognostic nutrition index as a predictor of coronary artery aneurysm in Kawasaki Disease
Ho-Chang Kuo
Kaohsiung Chang Gung Memorial Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0002-3295-2984
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Kawasaki Disease (KD) is considered a major acquired heart disease in children under the age of 5. Coronary artery aneurysm (CAA) can occur in serious cases despite extreme therapy efforts. Previous studies have reported low serum albumin level was associated with disease outcome, but no further investigation was addressed yet.
Method: This retrospective (case-control) study randomly included children with KD who were admitted and underwent laboratory tests before undergoing IVIG treatment in this institution, the largest tertiary medical center in southern Taiwan from 2012-2016. Prognostic nutrition index (PNI), an albumin-based formula product, was evaluated as a predictor of CAA the first time. The progression of CAA was monitored using serial echocardiography for six months. We performed multivariable logistic regression analysis on the laboratory test and PNI with the disease outcome of the KD patients.
Result: Of the 275 children, 149 had CAA, including transient dilatation, while the other 126 did not develop CAA during the 6-month follow-up period. A multivariate logistic regression model revealed that PNI, gender, IVIG non-responder, and platelet count are significant predictors of CAA with a 95% confidence interval estimator of 1.999, 3.058, 3.864 and1.004, respectively. Using PNI to predict CAA presence gave an area under the receiver-operating-characteristics (ROC) curve of 0.596. For a cutoff of 0.5 in the logistic regression model and the PNI cut-off point is taken as 55 together with IVIG non-responder, boy gender, and platelet count take into account, sensitivity and specificity were 65.7% and 70.4%.
Conclusion: PNI could be a candidate of adjunctive predictor of coronary artery aneurysm in addition to IVIG non-responder. Together with low PNI, IVIG non-responder, male gender and platelet count will give high odds to predict coronary artery aneurysm within 6 months of illness.
Keywords
Prognostic Nutrition Index, Kawasaki Disease, Coronary Artery Aneurysm, Albumin, Lymphocyte
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CURRENT STATUS: Under Review
Version 2
Posted 16 Apr, 2020
No community comments so far
Reviewer #1 agreed
On 17 Apr, 2020
Review #1 received
Received 17 Apr, 2020
Reviewers invited
Invitations sent on 14 Apr, 2020
Editor assigned
On 12 Apr, 2020
Submission checks complete
On 11 Apr, 2020
Editor invited
On 11 Apr, 2020
No comments provided
Editorial decision: Major revision
On 16 Mar, 2020
Review #3 received
Received 14 Mar, 2020
Reviewer #3 agreed
On 08 Mar, 2020
Review #2 received
Received 29 Feb, 2020
Reviewer #2 agreed
On 13 Feb, 2020
Review #1 received
Received 10 Feb, 2020
Reviewer #1 agreed
On 30 Jan, 2020
Reviewers invited
Invitations sent on 17 Jan, 2020
First submitted
On 27 Dec, 2019
Editor assigned
On 27 Dec, 2019
Submission checks complete
On 26 Dec, 2019
Editor invited
On 26 Dec, 2019
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This preprint is under consideration at BMC Pediatrics. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Prognostic nutrition index as a predictor of coronary artery aneurysm in Kawasaki Disease
Ho-Chang Kuo
Kaohsiung Chang Gung Memorial Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0002-3295-2984
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 2
Posted 16 Apr, 2020
No community comments so far
Reviewer #1 agreed
On 17 Apr, 2020
Review #1 received
Received 17 Apr, 2020
Reviewers invited
Invitations sent on 14 Apr, 2020
Editor assigned
On 12 Apr, 2020
Submission checks complete
On 11 Apr, 2020
Editor invited
On 11 Apr, 2020
No comments provided
Editorial decision: Major revision
On 16 Mar, 2020
Review #3 received
Received 14 Mar, 2020
Reviewer #3 agreed
On 08 Mar, 2020
Review #2 received
Received 29 Feb, 2020
Reviewer #2 agreed
On 13 Feb, 2020
Review #1 received
Received 10 Feb, 2020
Reviewer #1 agreed
On 30 Jan, 2020
Reviewers invited
Invitations sent on 17 Jan, 2020
First submitted
On 27 Dec, 2019
Editor assigned
On 27 Dec, 2019
Submission checks complete
On 26 Dec, 2019
Editor invited
On 26 Dec, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Kawasaki Disease (KD) is considered a major acquired heart disease in children under the age of 5. Coronary artery aneurysm (CAA) can occur in serious cases despite extreme therapy efforts. Previous studies have reported low serum albumin level was associated with disease outcome, but no further investigation was addressed yet.
Method: This retrospective (case-control) study randomly included children with KD who were admitted and underwent laboratory tests before undergoing IVIG treatment in this institution, the largest tertiary medical center in southern Taiwan from 2012-2016. Prognostic nutrition index (PNI), an albumin-based formula product, was evaluated as a predictor of CAA the first time. The progression of CAA was monitored using serial echocardiography for six months. We performed multivariable logistic regression analysis on the laboratory test and PNI with the disease outcome of the KD patients.
Result: Of the 275 children, 149 had CAA, including transient dilatation, while the other 126 did not develop CAA during the 6-month follow-up period. A multivariate logistic regression model revealed that PNI, gender, IVIG non-responder, and platelet count are significant predictors of CAA with a 95% confidence interval estimator of 1.999, 3.058, 3.864 and1.004, respectively. Using PNI to predict CAA presence gave an area under the receiver-operating-characteristics (ROC) curve of 0.596. For a cutoff of 0.5 in the logistic regression model and the PNI cut-off point is taken as 55 together with IVIG non-responder, boy gender, and platelet count take into account, sensitivity and specificity were 65.7% and 70.4%.
Conclusion: PNI could be a candidate of adjunctive predictor of coronary artery aneurysm in addition to IVIG non-responder. Together with low PNI, IVIG non-responder, male gender and platelet count will give high odds to predict coronary artery aneurysm within 6 months of illness.
Figure 1