Incidence and short-term outcomes of Kawasaki disease
Objective Kawasaki disease (KD) is a childhood vasculitis with conflicting reported North American trends in incidence and patient characteristics. Objectives: (1) determine KD incidence between 1995 and 2017; (2) compare patient characteristics by era and age group; (3) determine complication and c...
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| Veröffentlicht in: | Pediatric research 2021-09, Vol.90 (3), p.670-677 |
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| creator | Robinson, Cal Chanchlani, Rahul Gayowsky, Anastasia Brar, Sandeep Darling, Elizabeth Demers, Catherine Klowak, Jennifer Knight, Braden Kuenzig, Ellen Mondal, Tapas Parekh, Rulan Seow, Hsien Jimenez-Rivera, Carolina Webster, Richard Fung, Stephen Benchimol, Eric I. Batthish, Michelle |
| description | Objective
Kawasaki disease (KD) is a childhood vasculitis with conflicting reported North American trends in incidence and patient characteristics. Objectives: (1) determine KD incidence between 1995 and 2017; (2) compare patient characteristics by era and age group; (3) determine complication and cardiovascular follow-up rates.
Methods
We used population-based health administrative data to identify children (0–18 yr) hospitalized with KD in Ontario, Canada between 1995 and 2017. We excluded children with prior KD diagnosis or incomplete records. We determined the annualized incidence and follow-up trends.
Results
KD was diagnosed in 4,346 children between 1995 and 2017. Annual KD incidence was 22.0 ( |
| doi_str_mv | 10.1038/s41390-021-01496-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2507670698</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2582277832</sourcerecordid><originalsourceid>FETCH-LOGICAL-c419t-9d6a05d3de03b3a08cb23dab6a73a6f95410818952362254ca705a40a84a8ba03</originalsourceid><addsrcrecordid>eNp9kE1LxDAQhoMo7rr6BzxIwYuX6uSrSY6y-LG44EXPYdqm2nXbrkmL-O-NdlXw4Glg5pl3hoeQYwrnFLi-CIJyAykwmgIVJkvlDplSyWNLCLVLpgCcptwYPSEHIawgUlKLfTLhXGmplZkSuWiLunRt4RJsyyQ8d75Pe-ebpBv6omtcSLoqucM3DPhSJ2UdHAZ3SPYqXAd3tK0z8nh99TC_TZf3N4v55TItBDV9asoMQZa8dMBzjqCLnPES8wwVx6wyUlDQVBvJeMaYFAUqkCgAtUCdI_AZORtzN757HVzobVOHwq3X2LpuCJZJUJmCzOiInv5BV93g2_hdpDRjSmnOIsVGqvBdCN5VduPrBv27pWA_pdpRqo1S7ZdUK-PSyTZ6yBtX_qx8W4wAH4EQR-2T87-3_4n9AI14f58</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2582277832</pqid></control><display><type>article</type><title>Incidence and short-term outcomes of Kawasaki disease</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><source>SpringerLink Journals - AutoHoldings</source><creator>Robinson, Cal ; Chanchlani, Rahul ; Gayowsky, Anastasia ; Brar, Sandeep ; Darling, Elizabeth ; Demers, Catherine ; Klowak, Jennifer ; Knight, Braden ; Kuenzig, Ellen ; Mondal, Tapas ; Parekh, Rulan ; Seow, Hsien ; Jimenez-Rivera, Carolina ; Webster, Richard ; Fung, Stephen ; Benchimol, Eric I. ; Batthish, Michelle</creator><creatorcontrib>Robinson, Cal ; Chanchlani, Rahul ; Gayowsky, Anastasia ; Brar, Sandeep ; Darling, Elizabeth ; Demers, Catherine ; Klowak, Jennifer ; Knight, Braden ; Kuenzig, Ellen ; Mondal, Tapas ; Parekh, Rulan ; Seow, Hsien ; Jimenez-Rivera, Carolina ; Webster, Richard ; Fung, Stephen ; Benchimol, Eric I. ; Batthish, Michelle</creatorcontrib><description>Objective
Kawasaki disease (KD) is a childhood vasculitis with conflicting reported North American trends in incidence and patient characteristics. Objectives: (1) determine KD incidence between 1995 and 2017; (2) compare patient characteristics by era and age group; (3) determine complication and cardiovascular follow-up rates.
Methods
We used population-based health administrative data to identify children (0–18 yr) hospitalized with KD in Ontario, Canada between 1995 and 2017. We excluded children with prior KD diagnosis or incomplete records. We determined the annualized incidence and follow-up trends.
Results
KD was diagnosed in 4,346 children between 1995 and 2017. Annual KD incidence was 22.0 (<5 yr), 6.1 (5–9 yr), and 0.6 (10–18 yr) per 100,000 children. KD incidence increased significantly for all age groups, including from 18.4 to 25.0 cases per 100,000 children <5 yr. Ninety-day mortality occurred in ≤5 children (≤0.1%). Coronary artery aneurysm (CAA) occurred in 106 children (2.4%, 95% confidence interval 2.0–2.9) during admission and 151 (3.5%, 95% confidence interval 3.0–4.1) during 11-year median follow-up. Children 10–18 yr had longer hospitalizations (4.3 vs. 3.5 days,
p
= 0.003) and more CAA (7.4% vs. 3.4%,
p
= 0.007). By 1-year post-diagnosis, 3970 (91.3%) and 2576 (59.3%) children had echocardiography and cardiology follow-up, respectively.
Conclusions
KD incidence is increasing in Ontario, with greater healthcare utilization from hospitalizations and subsequent follow-up.
Impact
4346 children were hospitalized for Kawasaki disease over 22 years in Ontario, and Kawasaki disease incidence increased significantly for all age groups, males and females.
Older children (10–18 years) had longer hospital length of stay, more PICU admissions and more frequent coronary artery aneurysms.
Nearly all children with Kawasaki disease had follow-up echocardiography within 1 year.</description><identifier>ISSN: 0031-3998</identifier><identifier>EISSN: 1530-0447</identifier><identifier>DOI: 10.1038/s41390-021-01496-5</identifier><identifier>PMID: 33785879</identifier><language>eng</language><publisher>New York: Nature Publishing Group US</publisher><subject>Adolescent ; Age groups ; Aneurysms ; Child ; Child, Preschool ; Confidence intervals ; Coronary vessels ; Female ; Humans ; Incidence ; Kawasaki disease ; Male ; Medicine ; Medicine & Public Health ; Mucocutaneous Lymph Node Syndrome - epidemiology ; Mucocutaneous Lymph Node Syndrome - therapy ; Ontario - epidemiology ; Pediatric Surgery ; Pediatrics ; Population Study Article ; Retrospective Studies ; Risk Factors ; Treatment Outcome ; Trends</subject><ispartof>Pediatric research, 2021-09, Vol.90 (3), p.670-677</ispartof><rights>The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc 2021</rights><rights>2021. The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.</rights><rights>The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc 2021.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c419t-9d6a05d3de03b3a08cb23dab6a73a6f95410818952362254ca705a40a84a8ba03</citedby><cites>FETCH-LOGICAL-c419t-9d6a05d3de03b3a08cb23dab6a73a6f95410818952362254ca705a40a84a8ba03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/s41390-021-01496-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/s41390-021-01496-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33785879$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Robinson, Cal</creatorcontrib><creatorcontrib>Chanchlani, Rahul</creatorcontrib><creatorcontrib>Gayowsky, Anastasia</creatorcontrib><creatorcontrib>Brar, Sandeep</creatorcontrib><creatorcontrib>Darling, Elizabeth</creatorcontrib><creatorcontrib>Demers, Catherine</creatorcontrib><creatorcontrib>Klowak, Jennifer</creatorcontrib><creatorcontrib>Knight, Braden</creatorcontrib><creatorcontrib>Kuenzig, Ellen</creatorcontrib><creatorcontrib>Mondal, Tapas</creatorcontrib><creatorcontrib>Parekh, Rulan</creatorcontrib><creatorcontrib>Seow, Hsien</creatorcontrib><creatorcontrib>Jimenez-Rivera, Carolina</creatorcontrib><creatorcontrib>Webster, Richard</creatorcontrib><creatorcontrib>Fung, Stephen</creatorcontrib><creatorcontrib>Benchimol, Eric I.</creatorcontrib><creatorcontrib>Batthish, Michelle</creatorcontrib><title>Incidence and short-term outcomes of Kawasaki disease</title><title>Pediatric research</title><addtitle>Pediatr Res</addtitle><addtitle>Pediatr Res</addtitle><description>Objective
Kawasaki disease (KD) is a childhood vasculitis with conflicting reported North American trends in incidence and patient characteristics. Objectives: (1) determine KD incidence between 1995 and 2017; (2) compare patient characteristics by era and age group; (3) determine complication and cardiovascular follow-up rates.
Methods
We used population-based health administrative data to identify children (0–18 yr) hospitalized with KD in Ontario, Canada between 1995 and 2017. We excluded children with prior KD diagnosis or incomplete records. We determined the annualized incidence and follow-up trends.
Results
KD was diagnosed in 4,346 children between 1995 and 2017. Annual KD incidence was 22.0 (<5 yr), 6.1 (5–9 yr), and 0.6 (10–18 yr) per 100,000 children. KD incidence increased significantly for all age groups, including from 18.4 to 25.0 cases per 100,000 children <5 yr. Ninety-day mortality occurred in ≤5 children (≤0.1%). Coronary artery aneurysm (CAA) occurred in 106 children (2.4%, 95% confidence interval 2.0–2.9) during admission and 151 (3.5%, 95% confidence interval 3.0–4.1) during 11-year median follow-up. Children 10–18 yr had longer hospitalizations (4.3 vs. 3.5 days,
p
= 0.003) and more CAA (7.4% vs. 3.4%,
p
= 0.007). By 1-year post-diagnosis, 3970 (91.3%) and 2576 (59.3%) children had echocardiography and cardiology follow-up, respectively.
Conclusions
KD incidence is increasing in Ontario, with greater healthcare utilization from hospitalizations and subsequent follow-up.
Impact
4346 children were hospitalized for Kawasaki disease over 22 years in Ontario, and Kawasaki disease incidence increased significantly for all age groups, males and females.
Older children (10–18 years) had longer hospital length of stay, more PICU admissions and more frequent coronary artery aneurysms.
Nearly all children with Kawasaki disease had follow-up echocardiography within 1 year.</description><subject>Adolescent</subject><subject>Age groups</subject><subject>Aneurysms</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Confidence intervals</subject><subject>Coronary vessels</subject><subject>Female</subject><subject>Humans</subject><subject>Incidence</subject><subject>Kawasaki disease</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mucocutaneous Lymph Node Syndrome - epidemiology</subject><subject>Mucocutaneous Lymph Node Syndrome - therapy</subject><subject>Ontario - epidemiology</subject><subject>Pediatric Surgery</subject><subject>Pediatrics</subject><subject>Population Study Article</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Treatment Outcome</subject><subject>Trends</subject><issn>0031-3998</issn><issn>1530-0447</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kE1LxDAQhoMo7rr6BzxIwYuX6uSrSY6y-LG44EXPYdqm2nXbrkmL-O-NdlXw4Glg5pl3hoeQYwrnFLi-CIJyAykwmgIVJkvlDplSyWNLCLVLpgCcptwYPSEHIawgUlKLfTLhXGmplZkSuWiLunRt4RJsyyQ8d75Pe-ebpBv6omtcSLoqucM3DPhSJ2UdHAZ3SPYqXAd3tK0z8nh99TC_TZf3N4v55TItBDV9asoMQZa8dMBzjqCLnPES8wwVx6wyUlDQVBvJeMaYFAUqkCgAtUCdI_AZORtzN757HVzobVOHwq3X2LpuCJZJUJmCzOiInv5BV93g2_hdpDRjSmnOIsVGqvBdCN5VduPrBv27pWA_pdpRqo1S7ZdUK-PSyTZ6yBtX_qx8W4wAH4EQR-2T87-3_4n9AI14f58</recordid><startdate>20210901</startdate><enddate>20210901</enddate><creator>Robinson, Cal</creator><creator>Chanchlani, Rahul</creator><creator>Gayowsky, Anastasia</creator><creator>Brar, Sandeep</creator><creator>Darling, Elizabeth</creator><creator>Demers, Catherine</creator><creator>Klowak, Jennifer</creator><creator>Knight, Braden</creator><creator>Kuenzig, Ellen</creator><creator>Mondal, Tapas</creator><creator>Parekh, Rulan</creator><creator>Seow, Hsien</creator><creator>Jimenez-Rivera, Carolina</creator><creator>Webster, Richard</creator><creator>Fung, Stephen</creator><creator>Benchimol, Eric I.</creator><creator>Batthish, Michelle</creator><general>Nature Publishing Group US</general><general>Nature Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20210901</creationdate><title>Incidence and short-term outcomes of Kawasaki disease</title><author>Robinson, Cal ; Chanchlani, Rahul ; Gayowsky, Anastasia ; Brar, Sandeep ; Darling, Elizabeth ; Demers, Catherine ; Klowak, Jennifer ; Knight, Braden ; Kuenzig, Ellen ; Mondal, Tapas ; Parekh, Rulan ; Seow, Hsien ; Jimenez-Rivera, Carolina ; Webster, Richard ; Fung, Stephen ; Benchimol, Eric I. ; Batthish, Michelle</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c419t-9d6a05d3de03b3a08cb23dab6a73a6f95410818952362254ca705a40a84a8ba03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adolescent</topic><topic>Age groups</topic><topic>Aneurysms</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Confidence intervals</topic><topic>Coronary vessels</topic><topic>Female</topic><topic>Humans</topic><topic>Incidence</topic><topic>Kawasaki disease</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mucocutaneous Lymph Node Syndrome - epidemiology</topic><topic>Mucocutaneous Lymph Node Syndrome - therapy</topic><topic>Ontario - epidemiology</topic><topic>Pediatric Surgery</topic><topic>Pediatrics</topic><topic>Population Study Article</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Treatment Outcome</topic><topic>Trends</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Robinson, Cal</creatorcontrib><creatorcontrib>Chanchlani, Rahul</creatorcontrib><creatorcontrib>Gayowsky, Anastasia</creatorcontrib><creatorcontrib>Brar, Sandeep</creatorcontrib><creatorcontrib>Darling, Elizabeth</creatorcontrib><creatorcontrib>Demers, Catherine</creatorcontrib><creatorcontrib>Klowak, Jennifer</creatorcontrib><creatorcontrib>Knight, Braden</creatorcontrib><creatorcontrib>Kuenzig, Ellen</creatorcontrib><creatorcontrib>Mondal, Tapas</creatorcontrib><creatorcontrib>Parekh, Rulan</creatorcontrib><creatorcontrib>Seow, Hsien</creatorcontrib><creatorcontrib>Jimenez-Rivera, Carolina</creatorcontrib><creatorcontrib>Webster, Richard</creatorcontrib><creatorcontrib>Fung, Stephen</creatorcontrib><creatorcontrib>Benchimol, Eric I.</creatorcontrib><creatorcontrib>Batthish, Michelle</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Robinson, Cal</au><au>Chanchlani, Rahul</au><au>Gayowsky, Anastasia</au><au>Brar, Sandeep</au><au>Darling, Elizabeth</au><au>Demers, Catherine</au><au>Klowak, Jennifer</au><au>Knight, Braden</au><au>Kuenzig, Ellen</au><au>Mondal, Tapas</au><au>Parekh, Rulan</au><au>Seow, Hsien</au><au>Jimenez-Rivera, Carolina</au><au>Webster, Richard</au><au>Fung, Stephen</au><au>Benchimol, Eric I.</au><au>Batthish, Michelle</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incidence and short-term outcomes of Kawasaki disease</atitle><jtitle>Pediatric research</jtitle><stitle>Pediatr Res</stitle><addtitle>Pediatr Res</addtitle><date>2021-09-01</date><risdate>2021</risdate><volume>90</volume><issue>3</issue><spage>670</spage><epage>677</epage><pages>670-677</pages><issn>0031-3998</issn><eissn>1530-0447</eissn><abstract>Objective
Kawasaki disease (KD) is a childhood vasculitis with conflicting reported North American trends in incidence and patient characteristics. Objectives: (1) determine KD incidence between 1995 and 2017; (2) compare patient characteristics by era and age group; (3) determine complication and cardiovascular follow-up rates.
Methods
We used population-based health administrative data to identify children (0–18 yr) hospitalized with KD in Ontario, Canada between 1995 and 2017. We excluded children with prior KD diagnosis or incomplete records. We determined the annualized incidence and follow-up trends.
Results
KD was diagnosed in 4,346 children between 1995 and 2017. Annual KD incidence was 22.0 (<5 yr), 6.1 (5–9 yr), and 0.6 (10–18 yr) per 100,000 children. KD incidence increased significantly for all age groups, including from 18.4 to 25.0 cases per 100,000 children <5 yr. Ninety-day mortality occurred in ≤5 children (≤0.1%). Coronary artery aneurysm (CAA) occurred in 106 children (2.4%, 95% confidence interval 2.0–2.9) during admission and 151 (3.5%, 95% confidence interval 3.0–4.1) during 11-year median follow-up. Children 10–18 yr had longer hospitalizations (4.3 vs. 3.5 days,
p
= 0.003) and more CAA (7.4% vs. 3.4%,
p
= 0.007). By 1-year post-diagnosis, 3970 (91.3%) and 2576 (59.3%) children had echocardiography and cardiology follow-up, respectively.
Conclusions
KD incidence is increasing in Ontario, with greater healthcare utilization from hospitalizations and subsequent follow-up.
Impact
4346 children were hospitalized for Kawasaki disease over 22 years in Ontario, and Kawasaki disease incidence increased significantly for all age groups, males and females.
Older children (10–18 years) had longer hospital length of stay, more PICU admissions and more frequent coronary artery aneurysms.
Nearly all children with Kawasaki disease had follow-up echocardiography within 1 year.</abstract><cop>New York</cop><pub>Nature Publishing Group US</pub><pmid>33785879</pmid><doi>10.1038/s41390-021-01496-5</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0031-3998 |
| ispartof | Pediatric research, 2021-09, Vol.90 (3), p.670-677 |
| issn | 0031-3998 1530-0447 |
| language | eng |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection; SpringerLink Journals - AutoHoldings |
| subjects | Adolescent Age groups Aneurysms Child Child, Preschool Confidence intervals Coronary vessels Female Humans Incidence Kawasaki disease Male Medicine Medicine & Public Health Mucocutaneous Lymph Node Syndrome - epidemiology Mucocutaneous Lymph Node Syndrome - therapy Ontario - epidemiology Pediatric Surgery Pediatrics Population Study Article Retrospective Studies Risk Factors Treatment Outcome Trends |
| title | Incidence and short-term outcomes of Kawasaki disease |
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