Duplisea Michael J, Roberson Mya L, Chrisco Lori, Strassle Paula D, Williams Felicia N, Ziemer Carolyn M
University of North Carolina School of Medicine, Chapel Hill, North Carolina.
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
J Am Acad Dermatol. 2021 Oct;85(4):873-877. doi: 10.1016/j.jaad.2021.04.082. Epub 2021 Apr 30.
Age, bicarbonate, cancer, dialysis, 10% body surface area risk model (ABCD-10) has recently been proposed as an alternative to the SCORe of toxic epidermal necrolysis (SCORTEN) model for predicting in-hospital mortality in patients with Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN). In contrast to SCORTEN, ABCD-10 incorporates prior dialysis and upweights the impact of cancer.
To determine the performance of ABCD-10 compared with that of SCORTEN in mortality prediction at a large, tertiary burn center.
A retrospective analysis of 192 patients with SJS/TEN admitted to the North Carolina Jaycee Burn Center from January 1, 2009, to December 31, 2019, was conducted. Data on these patients were collected using the burn registry and a manual chart review. The performance of both the mortality prediction models was assessed using univariate logistic regression and the Hosmer-Lemeshow test.
The overall mortality was 22% (n = 43). Nine (5%) patients had cancer, and 7 (4%) had undergone prior dialysis; neither factor was associated with mortality (P = .11 and P = .62, respectively). SCORTEN was well calibrated to predict inpatient mortality (P = .82), whereas ABCD-10 appeared to have a poorer fit (P < .001) in these patients. Both the models showed good discrimination.
Small sample size.
SCORTEN was a better predictor of inpatient mortality than ABCD-10 in a North American cohort of patients treated at the tertiary burn center.
年龄、碳酸氢盐、癌症、透析、10%体表面积风险模型（ABCD - 10）最近被提议作为中毒性表皮坏死松解症严重程度评分（SCORTEN）模型的替代模型，用于预测史蒂文斯 - 约翰逊综合征和中毒性表皮坏死松解症（SJS/TEN）患者的住院死亡率。与SCORTEN不同，ABCD - 10纳入了既往透析情况，并加重了癌症的影响。
在一家大型三级烧伤中心，确定ABCD - 10与SCORTEN在死亡率预测方面的表现。
对2009年1月1日至2019年12月31日入住北卡罗来纳州杰西·杰克逊烧伤中心的192例SJS/TEN患者进行回顾性分析。使用烧伤登记册和人工病历审查收集这些患者的数据。使用单因素逻辑回归和Hosmer - Lemeshow检验评估两种死亡率预测模型的表现。
总死亡率为22%（n = 43）。9例（5%）患者患有癌症，7例（4%）曾接受透析；这两个因素均与死亡率无关（P分别为0.11和0.62）。SCORTEN能很好地校准以预测住院死亡率（P = 0.82），而在这些患者中，ABCD - 10的拟合度似乎较差（P < 0.001）。两种模型均显示出良好的区分度。
样本量小。
在北美一家三级烧伤中心接受治疗的患者队列中，SCORTEN比ABCD - 10更能准确预测住院死亡率。
