Multiple Emergency Department visits for a diagnosis of Kawasaki Disease: An Examination of Risk Factors and Outcomes

Objectives To determine predictors of more than one emergency department (ED) visit for a Kawasaki disease diagnosis in a quaternary care pediatric hospital and compare outcomes between patients with 1 versus > 1 visit for KD diagnosis. Study design Medical records of patients evaluated for KD between January 2006 and August 2018 at Boston Children’s Hospital were abstracted for demographic and clinical data. Predictors of > 1 visit were explored using logistic regression and CART analysis. Results Of 530 patients diagnosed with KD, 117 (22%) required multiple ED visits for KD diagnosis. Multivariable regression and CART analysis identified ≤ 2 KD criteria (OR, 33.9; 95% CI, 18.1-63.6), Conclusions Incomplete KD criteria, fewer days of fever, and non-White race were significant predictors of multiple ED visits for KD diagnosis in this single institution study. Our findings underscore the importance of maintaining a high index of suspicion for KD in patients with