Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Risk Prediction of In-Hospital Mortality for SJS/TEN

JAMA Dermatol; ePub 2019 Mar 6; Noe, et al

In a recent cohort study of patients with Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN), a 5-item mortality prediction model (ABCD-10; age, bicarbonate level, cancer, dialysis, and 10% involved body surface area [BSA]) accurately predicted in-hospital mortality, with discrimination that was not significantly different from Score of Toxic Epidermal Necrolysis (SCORTEN). Data from a multicenter cohort of patients aged ≥18 years treated for SJS/TEN were obtained from inpatient consult databases and electronic medical record systems at 18 medical centers in the US. Researchers found:

  • Among 370 patients (mean [SD] age 49.0 [19.1] years; 195 [52.7%] women), 54 (15.14%) did not survive to hospital discharge.
  • 5 covariates were independent predictors of in-hospital mortality: age in years, BSA in percentage of epidermal detachment, serum bicarbonate level <20 mmol/L, active cancer, and dialysis prior to admission.
  • The ABCD-10 model showed good discrimination (area under the curve [AUC], 0.816) and calibration.
  • For SCORTEN, the AUC was 0.827 and was not significantly different from that of the ABCD-10 model.
Citation:

Noe MH, Rosenbach M, Hubbard RA, et al. Development and validation of a risk prediction model for in-hospital mortality among patients with Stevens-Johnson syndrome/toxic epidermal necrolysis—ABCD-10. [Published online ahead of print March 6, 2019]. JAMA Dermatol. doi:10.1001/jamadermatol.2018.5605.

This Week's Must Reads

Dietary Changes: No Major Effect on Psoriasis, Dermatol Online J; 2019 Feb 15; Pona, et al

Influenza Vaccine Rates in Adults with Psoriasis, J Invest Dermatol; 2019 Feb; Noe, Shin, et al

Psoriasis and AD Share Inflammatory Components, J Invest Dermatol; ePub 2019 Jan 11; Tsoi, et al

Quality of Life Among Patients with Psoriasis, PsA, Arch Dermatol Res; ePub 2019 Mar 13; Duvetorp, et al

Psoriasis and Cardiometabolic Comorbidity in Women, Acta Derm Venereol; 2019 Mar 1; Blegvad, et al

Must Reads in Rare Diseases

Risk Prediction of In-Hospital Mortality for SJS/TEN, JAMA Dermatol; ePub 2019 Mar 6; Noe, et al

Lymph Node Ratio and Survival Post-MCC Surgery, JAMA Dermatol; ePub 2019 Mar 2; Cheraghlou, et al

Necrobiosis Lipoidica Linked with Diabetes, Obesity, JAMA Dermatology; ePub 2019 Feb 20; Hashemi, et al

List of medications linked to drug-induced lupus expands, Arnaud L et al. Ann Rheum Dis. 2019 Feb 4. doi: 10.1136/annrheumdis-2018-214598

Dermatomyositis, Negative ANA, and Malignancy Risk, J Am Acad Dermatol; ePub 2018 Nov 17; Hoesly, et al