68 - THE IMPACT OF KAWASAKI DIESASE ON SUBSEQUENT HOSPITAL ADMISSIONS: A NATIONWIDE STUDY IN SOUTH KOREA

Background:

Current management of acute KD has been established with IVIG and high-dose aspirin for anti-inflammatory reactions. The risk of subsequent admission risks for KD group has not been investigated.

Methods:

This study is based on nationwide health claims data from South Korean National Health Insurance Service (NHIS). We investigated 13,648 children born between 2007-2010 and underwent admission with KD before 2020. For the control group, we identified 803,216 children who had annual health check-up presented by Korean government between 18-36 months old and born between 2007-2010. Using negative binomial regression model, we identified risk of admission with infection (respiratory, gastrointestinal, genitourinary, acute otitis media, neurologic, viral), malignancy, autoimmune (rheumatology, type 1 diabetes mellitus), and allergic asthma before 2020.12.31. The diagnosis of subsequent admission was based on the diagnostic codes of the International Classification of Diseases 10th revision.

Results :

The median age of diagnoses with KD was 2.6 (interquartile range; 1.3, 4.1) years old. Overall, compared to the control group, the KD group had an increased risk of hospitalization for respiratory (incidence rate ratio 1.03; 95% confidence interval (CI) 1.00, 1.06)) and viral diseases (1.24; 1.10, 1.40), and an increased risk of autoimmune diseases (1.26; 1.10, 1.48). When confined to 1 year after initial KD admission, the risk of hospitalization for respiratory disease (0.88; 0.82, 0.95) and acute otitis media (0.90; 0.83, 0.97) was significantly lower. However, those associations became insignificant after 1 year of admission (1-2 years, 2-3 years after initial admission). Last, KD group also had decreased risk of allergic asthma (0.77; 0.72, 0.81).

Conclusion:
Using nationwide data, we showed that children with KD had diverging risks of subsequent pediatric disorders. Additionally, the risk of respiratory infections within 1 year of hospitalization was decreased, assuming implications with the KD treatments.