Pericardial effusion is associated with longer length of stay and higher risk of readmission in children with Kawasaki disease: a multicenter retrospective cohort study from the Pediatric Health Information System (PHIS)

Background: Pericardial effusion (PCE) can be associated with Kawasaki disease. Little is known about the effect of PCE on Kawasaki disease outcomes.

Methods: We performed a retrospective cohort study of the Pediatric Health Information System of children admitted with Kawasaki disease. Multivariate logistic regression was used to determine whether PCE was associated with longer length of stay or risk of readmission at thirty days. Covariates in the models were black race, discharge year, admission age, sex, median household income, intensive care unit stay, mechanical ventilation, and diagnostic codes for the following: infectious disease, neoplastic disease, renal disease, hypothyroidism, and anemia. Secondary analysis was performed to determine factors associated with a child having PCE.

Results: A total of 17,422 patients were in the cohort, of which 440 (3%) had PCE. Pericardial effusion was associated with longer hospital length of stay (adjusted odds ratio [aOR] = 1.23; p < 0.01) and greater risk of readmission at 30 days (aOR = 1.42; p = 0.03). Secondary analysis showed that black children were more likely to have PCE (aOR = 1.54, p < 0.01). (See Figure)

Conclusions: These data suggest delayed discharge in children with PCE and Kawasaki disease may decrease readmission. Special consideration should be given to the management of black children with Kawasaki disease.