Background Kawasaki disease is a systemic vasculitis of unknown etiology that can result in coronary artery aneurysms in up to 25% of patients.2 This an important cause of morbidity and mortality in this condition.1 In the longer term, patients with persistent coronary artery aneurysms can develop coronary artery stenosis.2 In 2017, the American Heart Association published an updated scientific statement on the diagnosis and management of Kawasaki Disease.1
Objectives This audit will assess the initial management of patients with suspected Kawasaki Disease.
The objectives are as follows:
Identify the duration of time between onset of fever and administration of intravenous immunoglobulin
Identify the duration of time between the administration of intravenous immunoglobulin and the initial echocardiogram
Methods The sampling unit was the Paediatric Cardiology department at Great Ormond Street Hospital. The population sample were all patients who were referred to the outpatient clinic for suspected Kawasaki Disease from August 2018 to August 2019. Data was retrospectively collected from eligible patients by reviewing the patient database. Data was analysed by calculating percentages. Data was collected between 18/08/19 – 19/08/19.
Results The results of this audit did not meet the audit standard that all patients with suspected Kawasaki Disease should receive intravenous immunoglobulin within 10 days of the onset of fever. Twenty-two of the twenty-five patients did receive intravenous immunoglobulins within 10 days of fever onset, however four patients did not. Of these four patients, one patient received it one day after admission to hospital, on day 11 after fever onset. One patient received it on the same day as admission to hospital, on day 12 after fever onset. One patient received it one day after admission to hospital, on day 14 after fever onset. One patient did not receive intravenous immunoglobulin.
The results of this audit found that twenty of the twenty-five received an initial ECHO within 7 days of intravenous immunoglobulin administration, however 5 patients did not.
Conclusions The results of this audit did not meet the audit standard that all patients with suspected Kawasaki Disease should receive intravenous immunoglobulin within 10 days of the onset of fever.
This audit has a number of limitations. First, it has a relatively small population sample. Second, six patients were not included in the results because ether the date of fever onset or the date of intravenous immunoglobulin administration was not recorded.
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