Crüger Anne-Mette Torp, Kaur-Knudsen Diljit, Zachariae Claus, Rasmussen Henrik Berg, Thomsen Simon Francis
Dermato-venerologisk Afdeling D, Bispebjerg Hospital, Bispebjerg Bakke 23, 2400 Copenhagen NV, Denmark.
Dan Med J. 2015 Aug;62(8):A5122.
The aim of this study was to examine risk factors and mortality among patients with erythema multiforme (EM), Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN).
This was a retrospective evaluation of the med-ical records of 250 patients from two Danish tertiary dermatological departments during a ten-year period.
In a total of 192 cases (77.4%), the primary diagnosis of EM (66.5%), SJS (62.2%) and TEN (100%) was confirmed, whereas the remaining cases (22.6%) were diagnosed differently. Antibiotics and allopurinol were predominantly associated with TEN, whereas SJS was associated with a broad spectrum of drugs. EM was related mainly to viral infections, predominantly herpes (30.6%); 38.2% of the causes of EM remained unknown. Patients with TEN had the highest mortality; i.e. 60% in the course of the ten-year study period: adjusted hazard ratio (HR) = 11.2 (95% confidence interval (CI): 3.65-34.35); p < 0.001 compared with EM patients. The risk of death was also increased among patients with SJS relative to patients with EM: HR = 2.60 (95% CI: 1.10-6.16); p = 0.030; however, this did not remain statistically significant after adjustment for age, co-morbidity, infection, cancer and polypharmacy, HR = 0.99 (95% CI: 0.38-2.57); p = 0.976.
We validated diagnoses in 250 patients with EM, SJS and TEN diagnosed during a ten-year period. The survival of patients with TEN was expectedly low compared with patients with EM. We extend previous findings by showing that after adjustment for confounders, the survival rates of SJS and EM are comparable.
none.
not relevant.
本研究旨在调查多形红斑（EM）、史蒂文斯-约翰逊综合征（SJS）和中毒性表皮坏死松解症（TEN）患者的危险因素及死亡率。
这是一项对丹麦两个三级皮肤科十年间250例患者病历的回顾性评估。
共确诊192例（77.4%），其中EM（66.5%）、SJS（62.2%）和TEN（100%）为初步诊断，其余病例（22.6%）诊断不同。抗生素和别嘌醇主要与TEN相关，而SJS与多种药物相关。EM主要与病毒感染有关，主要是疱疹（30.6%）；38.2%的EM病因不明。TEN患者死亡率最高；即在十年研究期间为60%：校正风险比（HR）=11.2（95%置信区间（CI）：3.65 - 34.35）；与EM患者相比，p < 0.001。SJS患者的死亡风险相对于EM患者也有所增加：HR = 2.60（95%CI：1.10 - 6.16）；p = 0.030；然而，在调整年龄、合并症、感染、癌症和多种药物治疗因素后，这一差异不再具有统计学意义，HR = 0.99（95%CI：0.38 - 2.57）；p = 0.976。
我们对十年间诊断的250例EM、SJS和TEN患者的诊断进行了验证。与EM患者相比，TEN患者的生存率预期较低。我们通过研究表明，在调整混杂因素后，SJS和EM的生存率相当，扩展了先前的研究结果。
无。
不相关。
