Mortality and risk factors on admission in toxic epidermal necrolysis: A cohort study of 59 patients
| Autor: | Tomoya Watanabe, Yukie Yamaguchi, Hideyuki Ishikawa, Yumiko Yamane, Yusuke Saigusa, Hirofumi Go, Kazuko Nakamura, Naoko Takamura, Michiko Aihara, Michiru Totsuka, Takeshi Kambara, Setsuko Matsukura, Yuko Watanabe, Shunsuke Takaki |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male lcsh:Immunologic diseases. Allergy 0301 basic medicine medicine.medical_specialty Adolescent SCORTEN Malignancy Logistic regression Severity of Illness Index Cohort Studies Young Adult 03 medical and health sciences 0302 clinical medicine Japan Adrenal Cortex Hormones Risk Factors Internal medicine Humans Immunology and Allergy Medicine Modified scoring model Mortality Child Blood urea nitrogen Aged Aged 80 and over Body surface area Receiver operating characteristic business.industry Mortality rate Anti-Inflammatory Agents Non-Steroidal Toxic epidermal necrolysis General Medicine Middle Aged Prognosis medicine.disease Anti-Bacterial Agents 030104 developmental biology 030228 respiratory system Child Preschool Stevens-Johnson Syndrome Anticonvulsants Female lcsh:RC581-607 business Cohort study |
| Zdroj: | Allergology International, Vol 70, Iss 2, Pp 229-234 (2021) |
| ISSN: | 1323-8930 |
| Popis: | Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but life-threatening disorders characterized by widespread epidermal necrosis of the skin and mucosa. The severity-of-illness scoring system for TEN (SCORTEN) was widely used since 2000 as a standard prognostic tool consisting of seven clinical values. Methods: To evaluate the prognosis using current treatments and risk factors for mortality, we retrospectively analyzed 59 cases of TEN, including SJS/TEN overlap treated in two university hospitals from January 2000 to March 2020. Results: The mortality rate of TEN was 13.6% (8/59). All patients treated with high-dose steroid administration in combination with plasma exchange and/or immunoglobulin therapy recovered. Logistic regression analysis showed nine clinical composite scores, namely: heart rate (≧120 bpm), malignancy present, percentage of body surface area with epidermal detachment (>10%), blood urea nitrogen (>28 mg/dL), serum bicarbonate level (252 mg/dL), age (≧71 years), the interval between disease onset and treatment initiation at the specialty hospital (≧8 days), and respiratory disorder within 48 h after admission. The receiver operating characteristic curves confirmed a high potential for predicting the prognosis of TEN. Conclusions: Recent developments in treatment strategies have contributed to the improved prognosis of TEN patients. A modified severity scoring model composed of nine scores may be helpful in the prediction of TEN prognosis in recent patients. Further large-scale studies are needed to confirm mortality findings to improve prognostication in patients with TEN. |
| Databáze: | OpenAIRE |
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