Thakur Vishal, Vinay Keshavamurthy, Kumar Sheetanshu, Choudhary Rajat, Kumar Ashok, Parsad Davinder, Kumaran Muthu Sendhil
Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
National Institute of Nursing Education, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Indian Dermatol Online J. 2021 Mar 2;12(2):258-265. doi: 10.4103/idoj.IDOJ_437_20. eCollection 2021 Mar-Apr.
Clinicodemographic and laboratory parameters predicting the outcome of Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) may vary among populations owing to genotypic and environmental variations. There is a scarcity of studies evaluating these parameters in Indian population.
To analyze clinicodemographic and laboratory parameters predicting disease outcome in patients of SJS/TEN.
Clinical records of patients admitted with a diagnosis of SJS/TEN from January 2014 to December 2018 were reviewed retrospectively with respect to data pertaining to clinicodemographic details, laboratory parameters, and disease outcome.
Of 51 patients included in the study, 24 (47.06%) were females. Anticonvulsants [phenytoin (19.6%), carbamazepine (13.7%), others (5.88%)] were the most commonly implicated drugs followed by NSAIDs (19.6%). The overall mortality was 21.6% [SJS (0%), SJS-TEN overlap (18.8%), and TEN (28.6%)]. The mean detached body surface area (BSA) (35.4% ± 10.4% vs. 25.7% ± 11.8%; = 0.02) was significantly higher among patients with mortality. Blood urea nitrogen, serum HCO levels, and random blood sugar were significantly associated with mortality. Presence of sepsis during the disease course was associated with higher mortality (9/12 vs. 2/39; = 0.001). Other components of SCORTEN like age and heart rate were not significantly associated with poor outcome in our study. None of our patients had associated malignancy.
A higher detached BSA, presence of sepsis, higher blood urea nitrogen and random blood sugar, and lower serum HCO levels were associated with mortality. Refinement of scoring systems predicting the outcome of SJS-TEN is needed for better disease prognostication.
由于基因型和环境差异，预测史蒂文斯-约翰逊综合征（SJS）/中毒性表皮坏死松解症（TEN）预后的临床人口统计学和实验室参数在不同人群中可能有所不同。在印度人群中评估这些参数的研究较少。
分析预测SJS/TEN患者疾病预后的临床人口统计学和实验室参数。
回顾性分析2014年1月至2018年12月诊断为SJS/TEN的住院患者的临床记录，涉及临床人口统计学细节、实验室参数和疾病预后的数据。
在纳入研究的51例患者中，24例（47.06%）为女性。抗惊厥药[苯妥英（19.6%）、卡马西平（13.7%）、其他（5.88%）]是最常涉及的药物，其次是非甾体抗炎药（19.6%）。总死亡率为21.6%[SJS（0%）、SJS-TEN重叠型（18.8%）和TEN（28.6%）]。死亡患者的平均体表面积分离率（BSA）（35.4%±10.4%对25.7%±11.8%；P=0.02）显著更高。血尿素氮、血清HCO₃⁻水平和随机血糖与死亡率显著相关。疾病过程中存在脓毒症与更高的死亡率相关（9/12对2/39；P=0.001）。在我们的研究中，SCORTEN的其他组成部分如年龄和心率与不良预后无显著相关性。我们的患者均无相关恶性肿瘤。
较高的体表面积分离率、脓毒症的存在、较高的血尿素氮和随机血糖以及较低的血清HCO₃⁻水平与死亡率相关。为了更好地进行疾病预后评估，需要完善预测SJS-TEN预后的评分系统。
