Study population
A total of 1,257 patients with KD at six institutions between June 2013
and May 2020 were retrospectively analyzed in the present study. The
diagnostic criteria for KD conformed to the guidelines of the AHA
2004[19], and subsequently, by the AHA 2017[20]. The exclusion
criteria were as follows: (1) History of KD; (2) incident cases in
receipt of IVIG treatment in another hospital; (3) non-use of IVIG
during hospitalization; (4) poor laboratory data records during
hospitalization; and (5) the patients with inflammatory diseases, immune
diseases, hematological diseases, metabolic diseases, cancer, liver and
kidney diseases, and other heart diseases. All children with KD were
treated with IVIG [1-2 g/(kg/day)] plus oral aspirin [30-50
mg/(kg/day)]. IVIG-resistant patients were those with recurrent fever
≥38°C and recrudescence of one or more of the initial symptoms, or
persistent fever for at least 36 h after completion of initial IVIG
infusion [19]. The present study was approved by the Ethics
Committee of the Affiliated Hospital of Southwest Medical University,
Sichuan Academy of Medical Sciences, Sichuan People’s Hospital,
The First People’s Hospital of Yibin, The Second People’s Hospital of
Yibin, Luzhou People’s Hospital, Southwest Medical University Affiliated
Hospital of traditional Chinese Medicine, which strictly complied with
the 1975 Helsinki Declaration, revised in 1996.
The clinical parameters of patients, such as age and sex, were collected
from the medical data. Laboratory investigations included the following:
The counts of white blood cells, neutrophils, lymphocytes, monocytes and
platelets, hemoglobin level, albumin level, serum sodium level and total
bilirubin were collected before IVIG treatment. The definitions of PNI,
NLR and PLR were shown as follows: PNI = albumin (g/L) + 5×total
lymphocyte count (109/L); NLR = neutrophil/lymphocyte
counts; and PLR = platelet/lymphocyte counts [10].