To explore the clinical application value of whole blood viscoelasticity coagulation function monitoring technique in detection of coagulation function in children with Kawasaki disease.

A total of 168 children with suspected Kawasaki disease who were sent for examination by multiple hospitals in Southwest China from January to October 2024 and diagnosed with Kawasaki disease by whole blood viscoelastic coagulation function monitoring technique by the third-party company Baorui Biotechnology Taizhou Co. Ltd. were selected as the research subjects. According to the course of disease, they were divided into acute phase group (n=114, disease course≤10 d) and subacute phase group (n=54, 10 d<disease course≤21 d) by retrospective analysis method. The whole blood viscoelasticity coagulation function monitoring technique was performed on the two groups of children with Kawasaki disease to detect activated coagulation time (ACT), coagulation rate (CR) and platelet function (PF) index. The activated partial thromboplastin time (APTT), fibrinogen (FIB) and platelet count (PLT) of plasma samples were detected by coagulation function and PF routine examination method. These detection indicators between two groups were statistically compared by independent-samples t test or paired chi-square test. Kappa consistency test was used to evaluate the consistency of whole blood viscoelasticity coagulation function monitoring technique with coagulation function and PF routine detection method for coagulation function in children with acute Kawasaki disease. Receiver operating characteristic (ROC) curve was adopted to evaluate the clinical differential diagnosis value of coagulation function indicators detected by whole blood viscoelasticity coagulation function monitoring technique on children with acute and subacute Kawasaki disease. The procedures followed in this study were approved by the ethics committee of Sichuan Second Hospital of Traditional Chinese Medicine [Approval No. 202402(K)-02]. There were no statistical differences in general clinical data such as age, gender composition ratio and body mass index (BMI) between two groups (P>0.05).

①ACT, CR and PF index of Kawasaki disease children in acute phase group were higher than those in subacute phase group (t=5.29, 5.26, 6.14; P<0.001), while PLT was lower than that in subacute phase group (t=10.05, P<0.001), and APTT and FIB revealed no statistical differences between groups (P>0.05). ②Among children with Kawasaki disease in acute phase group, the evaluation results of ACT and APTT, CR and FIB were statistically different (χ²=6.81, 9.00; P=0.009, 0.003). The consistencies of ACT with APTT, CR with FIB, and PF index with PLT detected by the above two methods were poor (Kappa value=0.035, 0.021, 0.060, all P>0.05). ③ROC curve analysis of ACT, CR and PF index and the combination of the three indicators in the differential diagnosis of children with Kawasaki disease in acute phase and subacute phase showed that the area under the curve (AUC) of ACT, CR and PF index alone and in combination for differential diagnosis of children with acute and subacute Kawasaki disease were 0.733 (95%CI: 0.652-0.814), 0.728 (95%CI: 0.644-0.813), 0.772 (95%CI: 0.695-0.849), and 0.864 (95%CI: 0.808-0.919), respectively, and the differences were statistically significant (P<0.001).

Compared with coagulation function and PF routine examination method, whole blood viscoelasticity coagulation function monitoring technique may be more accurate in judging coagulation function and PF in children with Kawasaki disease, and it can assist in the diagnosis of children with acute and subacute Kawasaki disease by detecting ACT, CR and PF index, and guide clinical treatment as soon as possible.