Association between aspirin dose and outcomes in patients with acute Kawasaki disease: A nationwide retrospective cohort study in Japan

Abstract

AbstractBackground Using a Japanese national inpatient database, this study aimed to identify the appropriate dose of aspirin to be prescribed to patients with acute Kawasaki disease. Method We identified patients with Kawasaki disease treated with intravenous immunoglobulin between 2010 and 2021.The outcomes included the occurrence of coronary artery abnormalities and intravenous immunoglobulin resistance, length of stay, and medical costs. Restricted cubic spline functions were performed to examine the association between aspirin dose and the outcomes. Results Data of 82109 patients were extracted from the database. Non-linear associations were observed between aspirin dose and the outcomes. In comparison with an aspirin dose of 30 mg/kg/day, the odds ratio (95% confidence interval) for coronary artery abnormalities was 1.40 (1.13–1.75) at 5 mg/kg/day. An aspirin dose of ≥ 30 mg/kg/day did not significantly change the odds ratio for coronary artery abnormalities. Intravenous immunoglobulin resistance was significantly lower at a dose of 60 mg/kg/day or over. Conclusions The results showed no significant association between aspirin escalation and CAAs in patients with acute KD. High-dose aspirin showed the potential to reduce hospital stay and medical costs without increasing complications.