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Performance of ABCD-10 and SCORTEN Mortality Prediction Models in a Cohort of Patients with Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis.

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BACKGROUND ABCD-10 has recently been proposed as an alternative to the SCORTEN model for predicting in-hospital mortality in patients with Stevens-Johnson syndrome and toxic epidermal necrolysis. In contrast to SCORTEN,… Click to show full abstract

BACKGROUND ABCD-10 has recently been proposed as an alternative to the SCORTEN model for predicting in-hospital mortality in patients with Stevens-Johnson syndrome and toxic epidermal necrolysis. In contrast to SCORTEN, ABCD-10 incorporates prior dialysis and upweights the impact of cancer. OBJECTIVE To determine ABCD-10's performance compared to SCORTEN in mortality prediction at a large, tertiary burn center. METHODS A retrospective analysis of 192 patients admitted to the North Carolina Jaycee Burn Center from 1 January 2009 to 31 December 2019 for Stevens-Johnson syndrome and toxic epidermal necrolysis. Data on these patients were collected using the burn registry and manual chart review. The performance of both mortality prediction models was assessed using univariate logistic regression and Hosmer Lemeshow's test. RESULTS Overall mortality was 22% (n=43). Nine (5%) patients had cancer and 7 (4%) had prior dialysis, and neither factor was associated with mortality (P=.11 and P=.62, respectively). SCORTEN was well calibrated to predict inpatient mortality (P=.82), while ABCD-10 appeared to have poorer fit (P<.001) in these patients. Both models showed good discrimination. LIMITATIONS Small sample size. CONCLUSION SCORTEN was a better predictor of inpatient mortality than ABCD-10 in a North American cohort of patients treated at a tertiary burn center.

Keywords: abcd; johnson syndrome; mortality; syndrome toxic; stevens johnson; toxic epidermal

Journal Title: Journal of the American Academy of Dermatology
Year Published: 2021

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