Gust Nina K B, Adams Rebecca M, Frei Ashley, Coughlin Michelle, Klein Justin, Ridelman Elika, Shanti Christina
Department of Surgery, Division of Pediatric Surgery, Children's Hospital of Michigan/Wayne State University, Detroit, MI 48201, USA.
J Burn Care Res. 2025 Jan 24;46(1):132-137. doi: 10.1093/jbcr/irae140.
The Severity-of-Illness Score for Toxic Epidermal Necrolysis (SCORTEN) is a system that predicts in-hospital mortality for Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN). The system is widely utilized in adults but not in pediatrics. We aim to determine the accuracy of the SCORTEN in pediatrics. A retrospective review of pediatric patients admitted to a verified pediatric burn center with SJS/TEN from 2008 to 2022 was performed. Twenty-four patients were analyzed. Ten patients had 0-1 SCORTEN risk factor, 13 had 2 risk factors, and 1 had 3 risk factors. There was no relationship between initial blood urea nitrogen, bicarbonate, glucose, or initial heart rate on the length of an intensive care unit (ICU) stay or ventilator days. Hospital length of stay and feeding tube days were positively related (P < .001) along with length of stay and maximum total body surface areas (P < .05). Hospital length of stay, ICU length of stay, and ventilator days were not statistically significant between those having 0-1 and 2 risk factors. This study suggests that the SCORTEN system is not useful for pediatrics and a different scoring system is needed, as SCORTEN overestimates mortality and does not have a relationship to outcome measures.
中毒性表皮坏死松解症疾病严重程度评分系统（SCORTEN）是一种预测史蒂文斯-约翰逊综合征/中毒性表皮坏死松解症（SJS/TEN）患者住院死亡率的系统。该系统在成人中广泛应用，但在儿科中尚未应用。我们旨在确定SCORTEN在儿科中的准确性。对2008年至2022年入住一家经过认证的儿科烧伤中心且患有SJS/TEN的儿科患者进行了回顾性研究。共分析了24例患者。10例患者有0 - 1个SCORTEN危险因素，13例有2个危险因素，1例有3个危险因素。初始血尿素氮、碳酸氢盐、血糖或初始心率与重症监护病房（ICU）住院时长或呼吸机使用天数之间没有关联。住院时长和鼻饲管使用天数呈正相关（P < .001），住院时长与最大体表面积也呈正相关（P < .05）。0 - 1个危险因素组和2个危险因素组之间的住院时长、ICU住院时长和呼吸机使用天数无统计学差异。本研究表明，SCORTEN系统对儿科患者无用，需要一种不同的评分系统，因为SCORTEN高估了死亡率，且与预后指标无关。
