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Int. J. Environ. Res. Public Health 2014, 11(4), 3705-3716; doi:10.3390/ijerph110403705

Association between Kawasaki Disease and Autism: A Population-Based Study in Taiwan

1
Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
2
Department of Business Management, National Taipei University of Technology, Taipei 106, Taiwan
3
Department of Healthcare Management, Yuanpei University, HsinChu 300, Taiwan
4
Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei 110, Taiwan
5
Shawnee, Kansas, 66226, USA
6
Department of Education & Research, Taipei City Hospital, Taipei 106, Taiwan
7
Department of Health Industry Management, School of Health Care Management, Kainan University, Taoyuan 338, Taiwan
8
Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
9
Department of Pharmacy, Taipei Medical University-Wan Fang Hospital, Taipei 116, Taiwan
10
Master Program for Clinical Pharmacogenomics and Pharmacoproteomics, School of Pharmacy, Taipei Medical University, Taipei 110, Taiwan
11
Cancer Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
These authors contributed equally to this work.
*
Author to whom correspondence should be addressed.
Received: 30 January 2014 / Revised: 14 March 2014 / Accepted: 24 March 2014 / Published: 3 April 2014
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Abstract

Objective: The association between Kawasaki disease and autism has rarely been studied in Asian populations. By using a nationwide Taiwanese population-based claims database, we tested the hypothesis that Kawasaki disease may increase the risk of autism in Taiwan. Materials and Methods: Our study cohort consisted of patients who had received the diagnosis of Kawasaki disease (ICD-9-CM: 446.1) between 1997 and 2005 (N = 563). For a comparison cohort, five age- and gender-matched control patients for every patient in the study cohort were selected using random sampling (N = 2,815). All subjects were tracked for 5 years from the date of cohort entry to identify whether they had developed autism (ICD-9-CM code 299.0) or not. Cox proportional hazard regressions were then performed to evaluate 5-year autism-free survival rates. Results: The main finding of this study was that patients with Kawasaki disease seem to not be at increased risk of developing autism. Of the total patients, four patients developed autism during the 5-year follow-up period, among whom two were Kawasaki disease patients and two were in the comparison cohort. Further, the adjusted hazard ratios (AHR) (AHR: 4.81; 95% confidence interval: 0.68–34.35; P = 0.117) did not show any statistical significance between the Kawasaki disease group and the control group during the 5-year follow-up. Conclusion: Our study indicated that patients with Kawasaki disease are not at increased risk of autism. View Full-Text
Keywords: Kawasaki disease; autism; population-based study; Taiwan population Kawasaki disease; autism; population-based study; Taiwan population
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MDPI and ACS Style

Kuo, H.-C.; Wu, C.-M.; Chang, W.-P.; Kuo, C.-N.; Yeter, D.; Lin, C.-Y.; Pai, J.-T.; Chi, Y.-C.; Lin, C.-H.; Wang, L.-J.; Chang, W.-C. Association between Kawasaki Disease and Autism: A Population-Based Study in Taiwan. Int. J. Environ. Res. Public Health 2014, 11, 3705-3716.

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