Scoring With SCORTEN

Collin, B; Marshall, T. D.; Heagerty, Adrian

doi:10.1001/archderm.139.9.1215-a

Arch Dermatol

2003

DOI: 10.1001/archderm.139.9.1215-a

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Scoring With SCORTEN

B Collin

T. D. Marshall²,

Adrian Heagerty

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Cited by 4 publications

(3 citation statements)

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“…12 Authors either only reported the calculated SCORTEN as a kind of clinical parameter or further used the score to estimate the expected mortality rate in their population to compare it with the observed mortality rate. In addition, SCORTEN was validated in different populations.…”

mentioning

confidence: 99%

Evaluation of SCORTEN on a Cohort of Patients With Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis Included in the RegiSCAR Study

Sekula

Liss

Davidovici

et al. 2011

Journal of Burn Care & Research

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The purpose of this study was to evaluate the severity-of-illness score called SCORTEN with respect to its predictive ability and by using data obtained in the RegiSCAR study, the most comprehensive European registry of patients with Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). For advanced comparisons, an auxiliary score (AS) was defined using data obtained in a previous study. Three hundred sixty-nine patients with SJS/TEN were included in RegiSCAR between 2003 and 2005. The data needed for calculation of SCORTEN were available for 45% of patients. The score revealed a moderate predictive ability with a slight underestimation of the total number of in-hospital deaths by 11%, an area under the receiver operating characteristic curve of 0.75, and a Brier score of 0.14. Problems could be seen by analyzing subgroups such as patients with TEN. The AS was better calibrated but discriminated worse (area under the receiver operating characteristic curve: 0.72; Brier score: 0.14). With the help of a refined score derived from SCORTEN and AS, potential for a possible improvement could be demonstrated. The authors were able to show that the predictive ability of SCORTEN is acceptable. Although improvement might be possible, SCORTEN remains the tool of choice, whereas AS might be an alternative in retrospective settings with missing laboratory data.

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mentioning

confidence: 99%

Evaluation of SCORTEN on a Cohort of Patients With Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis Included in the RegiSCAR Study

Sekula

Liss

Davidovici

et al. 2011

Journal of Burn Care & Research

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“…6 A severity-of-illness score for TEN (SCORTEN) was developed from a logistic regression model in 2000 in France. 5,7,8 Based on seven independent prognosis factors, it has gained wide acceptance in western countries. 6,[9][10][11] Authors either reported the calculated SCORTEN as a clinical parameter or additionally used the score to estimate the efficacy of new treatments.…”

mentioning

confidence: 99%

Toxic Epidermal Necrolysis

Zhu

Luo

et al. 2012

Journal of Burn Care & Research

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Toxic epidermal necrolysis (TEN) represents the most severe drug-related skin condition that is potentially life-threatening with no well-established treatments. The application of corticosteroid therapy is controversial, whereas recently intravenous immunoglobulin (IVIG) therapy is emerging as a promising new method. A severity-of-illness score for TEN (SCORTEN) has gained acceptance in some western countries. In this study, our objectives were to assess the applicability of SCORTEN in Chinese patients with TEN and to evaluate the efficacy of the combination therapy of IVIG and corticosteroid in these patients. We performed a retrospective review of data from 61 patients with TEN treated at our intensive care unit from 2000 to 2010 to assess the performance of SCORTEN. In particular, 55 patients between 2002 and 2010 were grouped as a series to compare the therapeutic effects of corticosteroid therapy and IVIG combined therapy contemporaneously. During this period, 16 patients were administered with corticosteroid therapy and 39 were treated with the combination therapy. An initial dose of 1.5 mg/kg/day of methylprednisolone was given to all TEN patients. The combination therapy was combined with a total dose of 2 g/kg IVIG within 5 days. Areas under receiver operating characteristic curves and Hosmer-Lemeshow statistic were analyzed to illustrate the performance of SCORTEN. The comparison of the efficacy of the two therapies was conducted on the basis of clinical outcomes, standardized mortality ratio (SMR), and survival analysis. The overall actual mortality of patients between 2000 and 2010 was 16% (10/61), statistically insignificantly lower than predicted (24%, SMR = 67.98). Excellent discriminatory power (the areas under the receiver operating characteristic curves: 88.9, 88.2, 90.6%) and good calibration (P = .637, .833, .530) were found in all the groups. In patients admitted between 2002 and 2010, IVIG combined therapy showed a trend toward reducing the mortality rate (13%, SMR = 52.35), whereas corticosteroid monotherapy suggested no such difference (31%, SMR = 123.92). Besides, the cumulative survival rates of the combination therapy were higher at almost all the levels of SCORTEN (P = .002), especially at the score of 5 (P = 3.10 × 10⁻⁷). Compared with corticosteroid alone, the combination therapy arrested progression earlier (P = .013), although it did not significantly lead to a tapering of corticosteroid or a reduction of the time of hospitalization. We concluded that SCORTEN was generally applicable to Chinese patients with TEN. The comparison of the effect indicated that the combination therapy might achieve a better therapeutic effect than the administration of corticosteroid alone, especially in severe TEN patients.

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“…Using the standardized mortality ratio, patients with TEN treated with IVIG were 84.5% less likely to die. [7][8][9] The findings of these research efforts were presented at the annual meetings of the Society of Investigative Dermatology and the American Academy of Dermatology and published in several papers in the Archives of Dermatology and the Journal of the American Academy of Dermatology. She received the University of Miami Celia and Samuel Resnik Award for Dermatology Resident Research for these findings.…”

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confidence: 99%

American Academy of Dermatology 2004 Awards for Young Investigators in Dermatology

2005

Journal of the American Academy of Dermatology

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Scoring With SCORTEN

Cited by 4 publications

References 3 publications

Evaluation of SCORTEN on a Cohort of Patients With Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis Included in the RegiSCAR Study

Evaluation of SCORTEN on a Cohort of Patients With Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis Included in the RegiSCAR Study

Toxic Epidermal Necrolysis

American Academy of Dermatology 2004 Awards for Young Investigators in Dermatology

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