Audit of compliance with Kawasaki disease diagnostic criteria and timely administration of IVIG

Abstract

Background: Kawasaki disease (KD) is an acute pediatric vasculitis and a leading cause of acquired heart disease in children. Objective: To assess compliance with Kawasaki disease diagnostic criteria and timely administration of IVIG in a tertiary care hospital.Methods: This retrospective clinical audit included 75 pediatric patients diagnosed with Kawasaki disease at Tertiary Care Hospital, Faisalabad from October 2024 to June 2025.  Audit standards were based on American Heart Association guidelines. Data were collected using a structured proforma and included documentation of fever duration, principal clinical criteria, evaluation of incomplete KD, laboratory investigations, echocardiography, IVIG dosing, and timing of administration. Results: The mean age was 3.8 ± 2.1 years, with 61.3% of patients under five years and 61.3% male. Fever duration ≥5 days was documented in 90.7% of cases, while complete documentation of all five principal criteria was achieved in 72.0%. Incomplete KD accounted for 28.0% of cases, with appropriate evaluation documented in 81.0%. Baseline laboratory investigations and echocardiography were performed in 96.0% and 93.3% of patients, respectively. Coronary artery abnormalities were identified in 12.0% of cases. IVIG was administered in 97.3% of patients, with correct dosing in 94.7%. Conclusion: Compliance with IVIG administration standards was generally high; however, gaps were identified in documenting diagnostic criteria and in timely treatment.