Kawasaki Disease

Pathway Background and Objectives

Kawasaki Disease is one of the most common vasculitides of childhood, and is the most common cause of acquired heart disease in children in developed countries. There is an estimated annual incidence of 20 per 100,000 children younger than five years in the United States, and prevalence is higher in Japan and in children of Japanese or East Asian descent. While it is typically a self-limited condition, complications such as coronary artery aneurysms, myocardial dysfunction, and heart failure may develop and lead to significant morbidity and mortality. The underlying etiology is unknown, and given the high risk of delayed diagnosis and/or treatment, it is imperative to standardize care to expedite recognition and timely treatment of Kawasaki Disease.

The objectives of this pathway are to:

  • Standardize care of patients with Kawasaki Disease and Incomplete Kawasaki Disease
  • Reduce the incidence of coronary artery aneurysms
  • Reduce the time to IVIG treatment
  • Reduce inpatient length of stay
  • If steroids are used, reduce the incidence of refractory Kawasaki Disease

Algorithm  Educational Module

 

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Attention: Critical Shortage of IV Methylprednisolone Nationwide

In order to preserve the limited supplies, please consider transitioning patients to PO steroids as soon as possible, if it is clinically appropriate. Conversion from IV to PO is 1:1 (i.e., the same dose for IV methylprednisolone should be used for PO prednisolone/prednisone).

  • Percentage of patients with pathway order set usage
  • Average time from admission to time of IVIG administration
  • Number of patients with coronary artery aneurysms or ectasia at diagnosis
  • Percentage of patients receiving medium dose aspirin in the acute phase of treatment
  • Number of patients receiving steroids upon initial diagnosis
  • Percentage of patients scheduled at discharge for follow up with a cardiologist
  • Average length of stay (days)
  • Number of patients readmitted due to Kawasaki Disease within 30 days
  • Marta Neubauer, MD
  • Alex Golden, MD
  • Melissa Held, MD
  • Heather Tory, MD

The clinical pathways in the above links have been developed specifically for use at Connecticut Children’s and are made available publicly for informational and/or educational purposes only. The clinical pathways are not intended to be, nor are they, a substitute for individualized professional medical judgment, advice, diagnosis, or treatment. Although Connecticut Children’s makes all efforts to ensure the accuracy of the posted content, Connecticut Children’s makes no warranty of any kind as to the accuracy or completeness of the information or its fitness for use at any particular facility or in any individual case.