Abstract
Background
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.
Methods
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.
Results
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.
Conclusions
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.
Résumé
Contexte
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.
Méthodologie
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.
Résultats
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.
Conclusions
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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Article info
Publication history
Published online: December 14, 2017
Accepted:
December 7,
2017
Received:
October 16,
2017
Footnotes
See editorial by Burns, pages 236–237 of this issue.
See page 308 for disclosure information.
Identification
Copyright
© 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Finding Kawasaki DiseaseCanadian Journal of CardiologyVol. 34Issue 3
- PreviewEpidemiologic 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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