Cognitive Development After Kawasaki Disease - Clinical Study and Validation Using a Nationwide Population-Based Cohort

Circ J. 2018 Jan 25;82(2):517-523. doi: 10.1253/circj.CJ-17-0557. Epub 2017 Sep 9.

Abstract

Background: This purpose of this study was to investigate whether Kawasaki disease (KD) increases the risk of cognitive impairment. In this clinical study, cognitive profiles were compared between KD patients, control subjects, and a nationwide population-based cohort to determine the potential correlation between KD and a subsequent diagnosis of an intellectual disability.Methods and Results:The clinical study consisted of 168 KD patients (mean age 5.6 years, 62.5% male) and 81 healthy controls (mean age 6.4 years, 54.3% male). The nationwide cohort consisted of 4,286 KD patients and 50,038 controls retrieved from the Taiwan National Health Insurance Research Database between 1996 and 2000. The clinical study sample revealed no significant difference in any developmental index or cognitive function between KD patients and controls across various age groups (P>0.05). In the nationwide cohort, Cox regression analysis showed that a diagnosis of KD did not significantly affect the likelihood of developing an intellectual disability (adjusted hazard ratio 0.87, 95% confidence interval 0.68-1.11).

Conclusions: Both the clinical data and the population-based cohort consistently demonstrated that KD does not increase a child's risk of future cognitive impairment. Although the outcome of the present study is negative, caregivers and patients with KD can be reassured that KD will have no effect on developmental milestones or cognitive function later in life.

Keywords: Circulation; Cognition; Intellectual disability; Kawasaki disease; Surveys.

Publication types

  • Clinical Study

MeSH terms

  • Case-Control Studies
  • Child
  • Child, Preschool
  • Cognition*
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Mucocutaneous Lymph Node Syndrome / epidemiology
  • Mucocutaneous Lymph Node Syndrome / psychology*
  • Proportional Hazards Models
  • Taiwan