Evidence map›Paper›PMID 38758423›Full record

ArticleDermatology and therapy2024

Evaluation of the Factors Influencing Mortality in Patients with Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Multicenter Study of 166 Patients.

Funda Erduran, Esra Adışen, Selma Emre, Yıldız Hayran, Emel Bülbül Başkan, Serkan Yazıcı, Aslı Bilgiç, Erkan Alpsoy, Sibel Doğan Günaydın, Leyla Elmas and 13 more

Abstract read
In one paragraph

Article in Dermatology and therapy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Guideline
  2. Pooled it
  3. Article
  4. Review
  5. Article
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

Funda ErduranAnkara Bilkent City Hospital, Department of Dermatology, Ankara, Turkey. fnderdrn@gmail.com.ORCID http://orcid.org/0000-0002-3318-2248
Esra AdışenDepartment of Dermatology, Gazi University, Ankara, Turkey.
Selma EmreDepartment of Dermatology, Ankara Yıldırım Beyazıt University, Ankara, Turkey.
Yıldız HayranAnkara Bilkent City Hospital, Department of Dermatology, Ankara, Turkey.
Emel Bülbül BaşkanDepartment of Dermatology, Bursa Uludağ University, Bursa, Turkey.
Serkan YazıcıDepartment of Dermatology, Bursa Uludağ University, Bursa, Turkey.
Aslı BilgiçDepartment of Dermatology, Akdeniz University, Antalya, Turkey.
Erkan AlpsoyDepartment of Dermatology, Akdeniz University, Antalya, Turkey.
Sibel Doğan GünaydınDepartment of Dermatology, Hacettepe University, Ankara, Turkey.
Leyla ElmasDepartment of Dermatology, Hacettepe University, Ankara, Turkey.
Melih AkyolDepartment of Dermatology, Sivas Cumhuriyet University, Sivas, Turkey.
RukiyeYasak GünerDepartment of Dermatology, Sivas Cumhuriyet University, Sivas, Turkey.
Deniz Aksu ArıcaDepartment of Dermatology, Karadeniz Technical University, Trabzon, Turkey.
Yağmur AypekDepartment of Dermatology, Gazi University, Ankara, Turkey.
Tülin ErgunDepartment of Dermatology, Marmara University, Istanbul, Turkey.
Dilan KaravelioğluDepartment of Dermatology, Marmara University, Istanbul, Turkey.
Ayça Cordan YazıcıDepartment of Dermatology, Mersin University, Mersin, Turkey.
Kübra AydoğanDepartment of Dermatology, Mersin University, Mersin, Turkey.
Dilek BayramgürlerDepartment of Dermatology, Kocaeli University, Kocaeli, Turkey.
Rebiay KıranDepartment of Dermatology, Kocaeli University, Kocaeli, Turkey.
Hilal Kaya ErdoğanDepartment of Dermatology, Eskişehir Osmangazi University, Eskişehir, Turkey.
Ersoy AcerDepartment of Dermatology, Eskişehir Osmangazi University, Eskişehir, Turkey.
Akın AktaşDepartment of Dermatology, Ankara Yıldırım Beyazıt University, Ankara, Turkey.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionStevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening acute mucocutaneous disorders usually triggered by drugs. In this study, we aimed to evaluate the factors affecting mortality in patients with SJS-TEN.

methodsOur study is a retrospective cohort study, analyzing data collected from a total of 12 tertiary care centers between April 2012 and April 2022.

resultsThe study included 59 males and 107 females, a total of 166 patients, with an average age of 50.91 ± 21.25 years. Disease classification was TEN in 50% of cases, SJS in 33.1%, and SJS-TEN overlap in 16.9%. The average SCORTEN within the first 24 h was 2.44 ± 1.42. Supportive care was provided to 99.4% of patients. The most commonly used systemic immunomodulatory treatments were systemic steroids (84.3%), IVIG (intravenous immunoglobulin) (49.3%), and cyclosporine (38.6%). Plasmapheresis was administered to five patients. While 66.3% of patients were discharged, 24.1% resulted in exitus. Our comparative analysis of survivors and deceased patients found no effect of systemic steroids, IVIG, and cyclosporine treatments on mortality. Univariate analysis revealed that the SCORTEN scores on days 1 and 3 as well as the rates of detachment at the onset and during follow-up were significantly higher in deceased patients compared to survivors. The rates of fever, positive blood cultures, and systemic antibiotic use were higher in deceased patients compared to survivors. The presence of comorbidities, diabetes, and malignancy were significantly more common in deceased patients. Multivariate regression analysis indicated that over SCORTEN 2, the mortality risk exponentially rose with each SCORTEN increment, culminating in an 84-fold increase in mortality at SCORTEN 5-6 (odds ratio [95% confidence interval]: 13.902-507.537, p < 0.001) compared to SCORTEN 0-1. Additionally, the utilization of plasmapheresis was associated with a 22-fold increase in mortality (odds ratio [95% confidence interval]: 1.96-247.2, p = 0.012).

conclusionOur study found that a high SCORTEN score within the first 24 h and the use of plasmapheresis were related to increased mortality, while systemic steroids, IVIG, and cyclosporine treatments had no impact on mortality. We believe that data gathered from one of the most comprehensive studies which we conducted on SJS-TEN will enrich the literature, although additional research is warranted.

Indexed as

MortalityPlasmapheresisSCORTENStevens-Johnson syndromeSurvivalToxic epidermal necrolysis

Identifiers

PMID38758423
PMCPMC11169098

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.