Systematic comparison of Kawasaki disease Z-score formulas: Enhancing diagnostic accuracy and clinical applicability across populations

Abstract

This study aims to evaluate the performance of six distinct Z-score formulas in diagnosing coronary artery dilation in Kawasaki disease (KD) patients, with a focus on their clinical applicability across diverse populations. A retrospective analysis was conducted using comparative statistical methods to assess the sensitivity and specificity of each formula. The Kobayashi and Dallaire formulas demonstrated the highest sensitivity in China, particularly in younger patients with prolonged fever duration. Our findings provide evidence-based recommendations for selecting Z-score formulas to optimize diagnostic precision in KD patients.

Keywords: Kawasaki disease; Early diagnosis; Z-score; Children

Core Tip: Kawasaki disease (KD) is a critical pediatric vasculitis, with coronary artery lesions (CALs) as its most severe complication. The coronary artery Z-score is a valuable metric for assessing coronary dilation in KD patients. This paper reviews six Z-score calculation formulas, with a focus on their clinical applicability in different populations. A retrospective study from Suzhou, China, shows that the Kobayashi and Dallaire formulas offer the best sensitivity and accuracy for Chinese children, leading to better diagnostic outcomes and improved management of CALs.