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Health Status of Adolescents after Kawasaki Disease

Purpose: We sought to determine the health status and quality of life of adolescents after Kawasaki disease (KD), and its relationship with disease status and patient characteristics. Methods: The Child Health and Illness Profile (CHIP) questionnaire was completed by 25 adolescents (mean age 14±3 years) at a mean interval of 12±3 years after acute KD. The health status domains assessed with standardized scores included satisfaction with one's health, physical and psychologic discomfort, resilience (behaviors which reduce likelihood of illness or injury), risk (behaviors which increase likelihood of illness or injury), disorders (acute and chronic mental and physical illness or injury), and achievement (school and work accomplishments). Results: Coronary artery involvement included none in 14 subjects (56%), resolved aneurysms in 7 (28%) and persistent aneurysms in 4 (16%). CHIP domain and subdomain scores were converted to Z scores (standard deviations from predicted normal). Mean Z scores for the domains were as follows: normal satisfaction, 0.05±0.81 (p=0.75 vs. normal); less discomfort, -0.44±0.84 (p=0.02); more resilience, 0.83±0.92 (p< 0.001); less risk, -0.70±0.67 (p< 0.001); normal disorders, 0.22±1.59 (p=0.50); and normal achievement, 0.24±0.97 (p=0.23). Scores were not significantly related to subject race, treatment with IV immune globulin or degree of coronary artery involvement. Older age was significantly related to higher scores for individual risk (eg. smoking, illicit drug use; r=0.40, p<0.05), peer influence (r=0.45, p=0.03), overall risk for injury or ill health (r=0.40, p<0.05), and lower scores for overall health status (r=-0.60, p=0.002), self-esteem (r=-0.36, p=0.08), and satisfaction (r=-0.57, p=0.003). Conclusion: While overall health status is normal, some domains indicate better than normal health status. Health status is unrelated to disease characteristics in this population, but there are trends towards lower health status with increasing age, which may reflect problems with adolescent adjustment.