Canadian Journal of Cardiology
Clinical Research| Volume 34, ISSUE 3, P303-309, March 2018

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Epidemiology of Kawasaki Disease in Canada 2004 to 2014: Comparison of Surveillance Using Administrative Data vs Periodic Medical Record Review

Published:December 14, 2017DOI:



      We have previously documented an increase in the incidence of Kawasaki disease (KD) in Ontario followed by a stabilization from 1995 to 2006. We sought to validate the estimation of incidence of KD using administrative data and to describe the epidemiology of KD across Canada from 2004 to 2014.


      We queried the Canadian Hospital Discharge Database for hospital admissions associated with a discharge diagnosis of KD. The data set was manually curated and estimates of incidence were compared with those obtained from the retrospective triennial surveillances of KD performed in 2007 and 2010.


      The average number of cases per year identified through administrative data was 245 ± 45 vs 229 ± 33 from retrospective surveillance. This overestimation, representing 7 ± 6%, is similar to the historical percentage of patients originally diagnosed with KD in whom the diagnosis is subsequently excluded. The annual incidence of KD in Canada was 19.6, 6.4, and 1.3 cases per 100,000 children younger than 5 years, 5-9 years, and 10-14 years old, respectively, with important regional and seasonal differences. The incidence remained stable over the study period in the youngest age group but increased in both older age categories. Coronary artery aneurysms affected 3.5% of all patients, and 0.8% experienced associated major cardiac complications.


      Reliance on administrative data to determine incidence of KD is feasible and accurate with manual curation of the data. The incidence of KD in Canada seems to have plateaued for younger children. Differences in annual incidence observed between provinces remain to be explained, and might reflect genetic or environmental differences.



      Nous avons déjà observé une augmentation de l’incidence du syndrome de Kawasaki en Ontario, suivie d’une stabilisation de 1995 à 2006. Nous voulions valider l’estimation de l’incidence du syndrome de Kawasaki au moyen de données administratives et décrire l’épidémiologie de cette maladie au Canada de 2004 à 2014.


      Nous avons interrogé la base de données canadienne sur les congés des patients à la recherche d’admissions à l’hôpital associées à un diagnostic de syndrome de Kawasaki à la sortie. Les données ont été triées manuellement, et les estimations de l’incidence ont été comparées avec celles qui ont été tirées des surveillances triennales rétrospectives du syndrome de Kawasaki réalisées en 2007 et en 2010.


      Le nombre moyen de cas par année déterminé à partir des données administratives était de 245 ± 45 contre 229 ± 33 d’après la surveillance rétrospective. Cette surestimation, représentant 7 ± 6 %, correspond au pourcentage historique de patients ayant reçu un diagnostic initial de syndrome de Kawasaki, mais dont le diagnostic a par la suite été exclu. Au Canada, l’incidence annuelle du syndrome de Kawasaki était de 19,6, de 6,4 et de 1,3 cas par 100 000 enfants de moins de 5 ans, de 5 à 9 ans et de 10 à 14 ans, respectivement, avec d’importantes différences régionales et saisonnières. L’incidence est demeurée stable sur la période de l’étude dans le groupe d’âge le plus jeune, mais a augmenté dans les deux groupes plus âgés. Des anévrismes artériels coronaires ont été observés chez 3,5 % de tous les patients, et 0,8 % ont subi des complications cardiaques majeures y étant associées.


      Une interrogation manuelle des données administratives permet d’établir une incidence fiable et exacte du syndrome de Kawasaki. L’incidence du syndrome de Kawasaki au Canada semble avoir atteint un plateau chez les jeunes enfants. Les disparités observées entre les provinces quant à l’incidence annuelle restent à expliquer et peuvent refléter des différences génétiques ou environnementales.
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      Linked Article

      • Finding Kawasaki Disease
        Canadian Journal of CardiologyVol. 34Issue 3
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          Epidemiologic research on Kawasaki disease (KD) is fraught with many hazards, not the least of which is the lack of a definitive diagnostic test. Thus, epidemiologists must rely on clinicians to recognize the classic features of the illness, gather supporting laboratory data, and eliminate other competing diagnoses as appropriate. This essentially guarantees that there will be over- as well as underdiagnosis of KD. Added to this problem, most countries or regions do not have prospective surveillance programs.
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