Objective To investigate the early predictive value of combined detection of serum sodium, heparin-binding protein-to-albumin ratio (HBP/ALB) and interleukin-10 (IL-10) in Kawasaki disease shock syndrome (KDSS) caused by Kawasaki disease in children.

Methods A total of 105 children with KDSS caused by Kawasaki disease (KDSS group) and 105 children with Kawasaki disease (control group) were selected as study subjects. Clinical data, serum sodium levels, HBP/ALB and IL-10 levels were compared between the two groups. Multivariate logistic regression analysis was used to screen the influencing factors of KDSS caused by Kawasaki disease in children among serum sodium, HBP/ALB and IL-10. Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the predictive value of traditional prediction schemes (coronary artery damage and IVIG resistance) and new prediction schemes (serum sodium and HBP/ALB, IL-10) for KDSS caused by Kawasaki disease in children.

Results The proportion of patients with coronary artery damage and IVIG resistance was significantly higher in the KDSS group than those in the control group (P < 0.05). Serum sodium levels were lower, while HBP/ALB and IL-10 levels were higher in the KDSS group compared to the control group (P < 0.05). Multivariate logistic regression analysis showed that serum sodium, BP/ALB and IL-10 were influencing factors of KDSS caused by Kawasaki diseasein children (P < 0.05). For traditional prediction schemes, the areas under the curves (AUCs) for coronary artery damage, IVIG resistance and their combination in predicting KDSS caused by Kawasaki disease were 0.795, 0.676 and 0.873, respectively (P < 0.05); for new prediction schemes, the AUCs for serum sodium, HBP/ALB, IL-10 and their combination in predicting KDSS were 0.767, 0.824, 0.760 and 0.945, respectively (P < 0.05). The AUC for the combination of serum sodium, HBP/ALB and IL-10 was greater than that for the combination of coronary artery damage and IVIG resistance (P < 0.05).

Conclusion Decreased serum sodium, elevated HBP/ALB and elevated IL-10 are associated with KDSS caused by Kawasaki disease in children. Combined prediction using serum sodium, HBP/ALB and IL-10 has a high predictive value for KDSS caused by Kawasaki disease in children.