Sekula Peggy, Liss Yvonne, Davidovici Batya, Dunant Ariane, Roujeau Jean-Claude, Kardaun Sylvia, Naldi Luigi, Schumacher Martin, Mockenhaupt Maja
Department of Medical Biometry and Statistics, Institute of Medical Biometry and Medical Informatics, University Medical Center Freiburg, Germany.
J Burn Care Res. 2011 Mar-Apr;32(2):237-45. doi: 10.1097/BCR.0b013e31820aafbc.
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.
本研究的目的是评估名为SCORTEN的疾病严重程度评分的预测能力，并利用在RegiSCAR研究中获得的数据进行评估。RegiSCAR研究是欧洲关于史蒂文斯-约翰逊综合征（SJS）和中毒性表皮坏死松解症（TEN）患者最全面的登记研究。为了进行进一步比较，使用先前研究中获得的数据定义了一个辅助评分（AS）。2003年至2005年期间，RegiSCAR纳入了369例SJS/TEN患者。45%的患者可获得计算SCORTEN所需的数据。该评分显示出中等的预测能力，住院死亡总数略有低估，低估了11%，受试者工作特征曲线下面积为0.75，Brier评分为0.14。通过分析TEN患者等亚组可以发现问题。AS校准得更好，但区分能力较差（受试者工作特征曲线下面积：0.72；Brier评分：0.14）。借助从SCORTEN和AS得出的改进评分，可以证明有可能进行改进。作者能够证明SCORTEN的预测能力是可以接受的。虽然可能有改进的空间，但SCORTEN仍然是首选工具，而AS可能是在实验室数据缺失的回顾性研究中的一种替代方法。
