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首页> 外文期刊>The Internet Journal of Asthma, Allergy and Immunology >Trends In Kawasaki Disease Hospitalizations: New York State 1990-2009
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Trends In Kawasaki Disease Hospitalizations: New York State 1990-2009

机译：川崎病住院治疗趋势：纽约州，1990-2009年

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Objective: To ascertain whether Kawasaki disease (KD) hospitalization patterns have shifted in New York State. Given the known prevalence changes in other disorders which involve hypersensitivity, KD trends are of interest.Design and setting: Analysis of an administrative hospitalization database between 1990-2009 in New York was performed to determine changes in Kawasaki disease hospitalization rates and assess therapeutic interventions and clinical manifestations. For trend comparisons, hospitalization rates were also examined in 2 other disorders with hypersensitivity components: asthma and anaphylaxis.Patients: De-identified inpatient recordsMain outcome measures: Hospitalization rate changes and associated clinical features over timeResults: There was a significant increase in KD hospitalizations over the study period (negative binomial regression, p<0.0001). In patients under the age of 5 (78% of all patients), the hospitalization rate was 14.6 per 100,000 in 1990. By 2002, the hospitalization rate reached an apex of 22.5 per 100,000. This trend differed from asthma and anaphylaxis hospitalizations, which showed an overall decline, and an overall continued increase, respectively. In patients who were Asian, Pacific-Islanders, Native Hawaiian or Native Americans, there was a greater increase in KD hospitalization rates than in other patients (negative binomial regression, p=0.003). Cardiac abnormalities were coded in 6.1% of hospitalizations. Four deaths were reported, only one of which was a likely cardiac death.Conclusion: In New York State, there have been unique dynamic changes in KD hospitalization rates, which are more accentuated in the Asian population. KD continues to be an uncommon but significant disorder which results in hospitalization for young children. Background & introduction Kawasaki disease (KD) is a self-limited vasculitis and the leading cause of acquired heart disease in the United States among children less than 5 years of age (1). It has a particular predilection for Asian populations, which is evidenced by higher hospitalization rates for this disorder in Japan, Taiwan and Hawaii (2-4). Although the etiology of the disorder is unknown, it is felt to be most likely secondary to infection and/or an altered immunologic response. The former is suggested by the fact that KD occurs in epidemics, is self-limited, and has a seasonal presentation. The later is evidenced by the response to immunomodulatory treatment with intravenous immunoglobulin (5). As there have been dynamic changes in the incidence other diseases that relate to hypersensitivity, such as asthma and anaphylaxis (6-7), it is of interest to examine whether the KD incidence has also changed. Moreover, in this study we examined a period of time and geographic area where there have been shifts in the racial proportions in a populous American state. These racial proportions have the potential for influencing the disease incidence. Methods De-identified in-patient data was obtained from the New York State Department of Health Statewide Planning and Research Cooperative System (SPARCS) database (8) for 1990 through 2009. The database has been previously described and utilized in studies examining disease states and hospital practice trends (9-10). Each SPARCS patient record contains data fields that include principal and non-principal diagnostic fields, accommodation and ancillary charges, procedure codes, race, age, gender, and ethnicity information, hospital characteristics, expected reimbursement, total charges, length of stay, admission and disposition status. This study was approved by the institutional research board of New York Downtown Hospital. Kawasaki disease was identified using the ICD-9 code 446.1. Hospitalizations with this code as the principal diagnosis were considered KD hospitalizations. To determine hospitalization rates, the number of hospitalizations for New York residents was divided by the estimated population. Estimated
机译：目的：确定纽约州的川崎病（KD）住院模式是否发生了变化。考虑到其他涉及超敏反应的疾病的已知患病率变化，人们对KD趋势很感兴趣。设计和设置：对1990-2009年间纽约的行政住院数据库进行了分析，以确定川崎病住院率的变化并评估治疗干预措施和临床表现。为了进行趋势比较，还检查了其他2种具有超敏成分的疾病的住院率：哮喘和过敏反应患者：住院记录不明确主要结局指标：住院率随时间的变化和相关的临床特征结果：KD住院率显着增加研究期（负二项式回归，p <0.0001）。在5岁以下的患者中（占所有患者的78％），1990年的住院率为14.6 / 10万。到2002年，住院率达到最高的22.5 / 10万。这种趋势不同于哮喘和过敏性住院，后者分别显示总体下降和总体持续增长。在亚洲，太平洋岛民，夏威夷原住民或美洲原住民的患者中，KD住院率的增加比其他患者更大（负二项式回归，p = 0.003）。 6.1％的住院患者编码心脏异常。据报道有4例死亡，其中只有1例可能是心源性死亡。结论：在纽约州，KD住院率有独特的动态变化，在亚洲人群中更为突出。 KD仍然是一种罕见但严重的疾病，导致幼儿住院。背景与简介川崎病（KD）是一种自限性血管炎，是美国5岁以下儿童后天性心脏病的主要原因（1）。它在亚洲人群中尤为偏爱，这在日本，台湾和夏威夷的这种疾病的较高住院率中得到了证明（2-4）。尽管该病的病因尚不清楚，但它被认为最有可能继发于感染和/或免疫应答改变。前者由以下事实表明：KD发生在流行病中，具有自限性，并且具有季节性表现。后者通过静脉注射免疫球蛋白对免疫调节治疗的反应得到证实（5）。由于发病率发生了动态变化，其他与超敏反应有关的疾病，例如哮喘和过敏反应（6-7），研究KD发病率是否也发生了变化是很有意义的。此外，在这项研究中，我们考察了人口稠密的美国州的种族比例发生变化的一段时间和地理区域。这些种族比例有可能影响疾病的发病率。方法从1990年至2009年的纽约州卫生部全州计划与研究合作系统（SPARCS）数据库（8）中获得身份不明的住院患者数据。该数据库先前已被描述并用于检查疾病状态和疾病的研究。医院实践趋势（9-10）。每个SPARCS患者记录均包含数据字段，这些数据字段包括主要和非主要诊断字段，住宿和辅助费用，程序代码，种族，年龄，性别和种族信息，医院特征，预期报销，总费用，住院时间，入院和处置状态。该研究得到纽约市中心医院机构研究委员会的批准。使用ICD-9代码446.1确定了川崎病。以该代码为主要诊断的住院被认为是KD住院。为了确定住院率，将纽约居民的住院次数除以估计的人口数。估计的

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