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An Evaluation of Hospitalizations for Kawasaki Syndrome in Georgia
Robert V. Gibbons, MD;
Umesh D. Parashar, MBBS;
Robert C. Holman, MS;
Ermias D. Belay, MD;
Ryan A. Maddox, MPH;
Kenneth E. Powell, MD;
Lawrence B. Schonberger, MD
Arch Pediatr Adolesc Med. 2002;156:492-496.
Objective To evaluate and describe the epidemiologic characteristics of Kawasaki
syndrome (KS) hospitalizations in Georgia.
Design We reviewed hospital discharge data and corresponding medical records
for Georgian patients discharged with a KS diagnosis during 1997 and 1998.
Results During the study period, 233 KS hospital discharges were recorded in
Georgia; 177 (76%) were for children younger than 5 years. Twenty-one (9%)
of 233 of the hospital discharges represented multiple hospitalizations. Medical
records for 211 KS discharges (91%), representing 197 patients (93%), were
reviewed. For those 189 patients whose medical records were reviewed and had
sufficient information, 139 (74%) either had a documented illness that met
the Centers for Disease Control and Prevention (CDC) definition for KS (n
= 135) or had coronary artery abnormalities without meeting the CDC definition
for KS (atypical KS; n = 4). Eight patients had only a history of KS. Excluding
multiple hospitalizations and patients with only a history of KS, 158 hospitalizations
were for patients younger than 5 years (14.0 per 100 000 children); 110
of these patients met the KS or atypical KS definition (9.8 per 100 000
children).
Conclusions Hospital discharge data are useful for KS surveillance. However, analysis
of hospital discharge data may slightly overestimate the KS hospitalization
rates because some discharges may represent multiple hospitalizations or hospitalizations
of patients with only a history of KS. The incidence and epidemiology of KS
in Georgia are consistent with findings from other continental US studies.
Physicians should exercise their best clinical judgment in identifying and
treating patients with KS who may not meet standard case definitions.
From the Division of Viral and Rickettsial Diseases, National Center
for Infectious Diseases (Drs Gibbons, Parashar, Belay, and Schonberger and
Messrs Holman and Maddox), and Epidemic Intelligence Service (Dr Gibbons),
Centers for Disease Control and Prevention, and the Epidemiology Branch, Division
of Public Health, Georgia Department of Human Resources (Drs Parashar and
Powell), Atlanta. Dr Gibbons is currently with the Walter Reed Army Institute
of Research, Silver Spring, Md.
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