Utilidad del Score de Harada (SH) como predictor de lesión coronaria en pacientes con diagnóstico de enfermedad de Kawasaki (EK) atendidos en el Hospital de Niños “Dr. Roberto Gilbert Elizalde” de enero 2018 a diciembre 2022.

Abstract

The Kawasaki disease (KD) is an acute vasculitis most common in children under five, which can lead to coronary aneurysms. This study assessed the utility of the Harada score (HS) as a predictor of coronary lesions in patients with KD at the “Dr. Roberto Gilbert Elizalde” Children's Hospital from January 2018 to December 2022. Ninety-six patients were included, of whom 65 were male and 31 female, corresponding to 67% and 33%, respectively. A prevalence of 21.88% of coronary lesions was found, indicating that 1 in 5 patients presented complications. The most frequent signs were: fever (100%), rash (87%), conjunctival hyperemia (75%), oral involvement (73%), extremity involvement (72%), and cervical lymphadenopathy (67%), which is consistent with the standard diagnostic criteria for KD. A cutoff point of 4 was established, achieving a sensitivity of 65% and specificity of 28%, which increases the likelihood of false positives. However, due to the risk of not identifying patients with coronary lesions, the approach continues to prioritize sensitivity, consistent with the study's objective. This study showed moderate performance as a predictor of coronary lesions, with an AUC of 0.67, indicating a limited ability to distinguish between patients with or without coronary complications. In conclusion, the Harada score is a tool to identify high-risk populations for developing coronary lesions; however, in our population, it did not achieve significant sensitivity and specificity as observed in the Japanese population where it was developed. Future multicentric studies are needed to validate these findings and explore additional risk factors in diverse populations.