von Wild Tobias, Stollwerck Peter L, Namdar Thomas, Stang Felix H, Mailänder Peter, Siemers Frank
Department of Plastic and Hand Surgery, Burn Unit, University Hospital Schleswig-Holstein Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany.
Eplasty. 2012;12:e35. Epub 2012 Aug 2.
Toxic epidermal necrolysis and Stevens-Johnson syndrome have related high morbidity and mortality. We predict that preexisting multimorbidity is a major prognostic factor of both these diseases.
A retrospective analysis in toxic epidermal necrolysis and Stevens-Johnson syndrome patients over the past 10 years. Three severity categories (minor, moderate, and severe multimorbidity) were defined according to a point-rating system.
Twenty-seven inpatients, with a median age of 63 years, diagnosed with toxic epidermal necrolysis (n = 13) or Stevens-Johnson syndrome/toxic epidermal necrolysis (n = 14) were assessed in this study. Of these, 14 patients died during the course of the study. Nonsurvivors showed significantly higher multimorbidity (P = .038), with higher scoring on the points system for disease severity (P = .003), than survivors and CART (Classification and Regression Trees) cross-validation (P < .05).
Restricted number of patients due to low prevalence rate.
The complexity of associated multimorbidity appears to have a large influence on toxic epidermal necrolysis and Stevens-Johnson syndrome prognosis, which has not been considered in any of the established scoring systems.
中毒性表皮坏死松解症和史蒂文斯-约翰逊综合征具有较高的发病率和死亡率。我们预测，预先存在的多种疾病是这两种疾病的主要预后因素。
对过去10年中毒性表皮坏死松解症和史蒂文斯-约翰逊综合征患者进行回顾性分析。根据评分系统定义了三个严重程度类别（轻度、中度和重度多种疾病）。
本研究评估了27名住院患者，中位年龄为63岁，诊断为中毒性表皮坏死松解症（n = 13）或史蒂文斯-约翰逊综合征/中毒性表皮坏死松解症（n = 14）。其中，14名患者在研究过程中死亡。与幸存者相比，非幸存者的多种疾病发生率显著更高（P = .038），疾病严重程度评分系统得分更高（P = .003），且分类回归树交叉验证结果显示差异有统计学意义（P < .05）。
由于患病率低，患者数量有限。
相关多种疾病的复杂性似乎对中毒性表皮坏死松解症和史蒂文斯-约翰逊综合征的预后有很大影响，而在任何既定的评分系统中均未考虑这一点。
