How Does SCORTEN Score?

Zavala, Sarah; O'Mahony, Megan; Joyce, Cara; Baldea, Anthony

doi:10.1093/jbcr/irx016

Cited by 22 publications

(23 citation statements)

References 9 publications

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“…However, SCORTEN accuracy has been questioned and its reformulation suggested for several reasons. First, continuous variables such as age or laboratory parameters were simplified and categorized into dichotomies in the design of SCORTEN, resulting in a loss of information that could slightly reduce the predictive ability of the score.…”

Section: Discussionmentioning

confidence: 99%

“…The use of the SCORTEN score has been quite successful for almost two decades [5][6][7] ; nevertheless, since its construction several studies have questioned the accuracy of this parameter. [8][9][10][11][12][13] The focus of the criticisms points especially on the need to review the parameters that comprise the SCORTEN score, its specific weight in the final result and the addition of other factors related to pre-existing comorbidities 8,14,15 or newly emerging ones, as it is the case of impaired renal or pulmonary function. [7][8][9][10][11][12][13][14]16 Furthermore, no previous meta-analysis evaluating the prognostic validity of the SCORTEN scale has been performed, remaining somehow unclear the precision of this scale.…”

Section: Introductionmentioning

confidence: 99%

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Accuracy of SCORTEN to predict the prognosis of Stevens‐Johnson syndrome/toxic epidermal necrolysis: a systematic review and meta‐analysis

Torres‐Navarro

Briz‐Redón

Botella‐Estrada

2020

Acad Dermatol Venereol

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Background The SCORTEN score is a specific predictor of the probability of death for patients diagnosed with Stevens‐Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN). Objectives To evaluate the overall accuracy of SCORTEN and the influence of several moderators such as age, sex, geographical region and age of the study. Methods A systematic search was performed on MEDLINE, The Cochrane Library, EMBASE, SCOPUS and Web of Knowledge, with no restriction on language (last update 5 February 2019 for all databases). Original studies on the use of SCORTEN were eligible. The standardized mortality ratio (SMR), defined as the quotient between the number of deaths observed and the number expected following SCORTEN, was taken as the measurement of analysis. Results Sixty‐four papers were part of the main meta‐analysis carried out in the study. A pooled log(SMR) of −0.0889 (95% CI: −0.2023 to 0.0245) was obtained, suggesting a reasonable behaviour of SCORTEN as a predictor of mortality. The possible influence of several factors in the accuracy of SCORTEN was studied by means of meta‐regression models. Multivariate meta‐regression allowed finding that the mean age of the patients and the ending year of the study are the only factors that significantly influence SCORTEN predictions. The mean age of the group of patients was associated with a significant increase in the observed/expected ratio, whereas a progressive reduction in the observed/expected ratio can be appreciated over the years. Finally, an underestimation of mortality was found for SCORTEN values of 3 or less and the opposite for those above 3 (SCORTEN range: 0–7). Conclusions The rarity of the disease and the heterogeneity of the studies included are major limitations. Despite the overall remarkable accuracy displayed by SCORTEN, the influence of several factors, as comorbidities (e.g. renal impairment), involved body surface area and patient's age, seem of enough relevance to consider a redefinition of the scale.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Accuracy of SCORTEN to predict the prognosis of Stevens‐Johnson syndrome/toxic epidermal necrolysis: a systematic review and meta‐analysis

Torres‐Navarro

Briz‐Redón

Botella‐Estrada

2020

Acad Dermatol Venereol

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“…The ARF is indirectly reflected in the SCORTEN score. In ABCD‐10, special emphasis is placed on previous dialysis, which makes sense because the clearance of the causative drug is decreased; therefore, dialysis predisposes to infections and greater hemodynamic control is required 2,7,12,13 . However, both scores suffer from defects in the assessment of kidney function.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of SCORTEN and ABCD‐10 to predict mortality and the influence of renal function in Stevens–Johnson syndrome/toxic epidermal necrolysis

Torres‐Navarro

Briz‐Redón

Botella-Casas

et al. 2020

The Journal of Dermatology

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Epidermal necrolysis (EN) compromises a spectrum of life-threatening dermatoses (Stevens-Johnson Syndrome [SJS], overlap syndrome and toxic epidermal necrolysis [TEN]). Currently, no active therapeutic regimen with unequivocal benefit exists for SJS/TEN. SCORTEN is the widely-used prognostic scale specific for SJS/TEN. Nevertheless, a new prognostic scale, the ABCD-10, has been recently proposed. In this context, acute renal failure (ARF) seems to be an important comorbidity that could influence prognosis in SJS/TEN patients more than it is assumed by these two scales. Our objectives were to compare the accuracy of the SCORTEN and ABCD-10 scales in predicting the mortality in SJS/TEN, and to investigate the influence of renal failure on prognosis. The prognostic results of 18 patients with EN treated in two referral centers between 2013 and 2018 are presented. SCORTEN, ABCD-10 and renal function values were retrospectively collected for all patients. Out of the 18 patients who were analyzed, nine (50%) received only supportive therapy, four were treated with etanercept 50 mg in a single dose (22.2%) and five with corticosteroids (27.8%). Five patients developed ARF. Predicted mortality was 3.48 for SCORTEN and 2.33 for ABCD-10. Eventually, four patients died (22.2%), all had ARF and none of them received active treatment. Despite study limitations and in the absence of active treatment of choice, SCORTEN behaved as a reliable predictor of mortality in patients with EN, outperforming the newer ABCD-10. ARF was an early event associated with a poor prognosis, which could represent a prognostic marker to consider in the future.

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“…The modifi ed SCORTEN scoring system has been used in recent years to evaluate severe bullous drug eruption. [13][14][15] Among the seven indicators, age, malignant tumors, blood sugar, bicarbonate, blood urea nitrogen, affected BSA, and heart rate are related to the severity of the underlying diseases, which suggests that patients' condition and underlying diseases are important. The disease severity can be assessed at an early stage.…”

Section: Discussionmentioning

confidence: 99%

Drug-induced erythroderma in patients with acquired immunodeficiency syndrome

Zhu¹,

Fang²,

Fang³

2021

World Journal of Emergency Medicine

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BACKGROUND: To explore the clinical manifestations, diagnosis, and treatment of patients with acquired immunodefi ciency syndrome (AIDS) complicated with drug-induced erythroderma. METHODS:The clinical data of 12 AIDS patients with drug-induced erythroderma in our hospital were retrospectively analyzed. The general information, offending medications, complications, modified severity-of-illness score for toxic epidermal necrolysis (SCORTEN) scores, and disease outcome spectrums were analyzed.RESULTS: Drug-induced erythroderma was mostly caused by antiviral drugs, antituberculosis drugs, antibiotics, traditional Chinese medicine, and immune checkpoint inhibitors. The spectrum of sensitizing drugs was broad, the clinical situation was complex, and infections were common. The affected areas were greater than 40% body surface area in all patients. The modified SCOTERN score averaged 3.01±0.99. All patients were treated with glucocorticoids, and nine patients were treated with intravenous immunoglobulin (IVIG) pulse therapy at the same time. The average time to effectiveness was 7.08±2.23 days, and the average hospital stay was 17.92±8.46 days. Eleven patients were cured, and one patient died of secondary multiple infections, who had a modified SCORTEN score of 5 points. The mortality rate in this study was 8.3%. CONCLUSIONS:The clinical situation of AIDS patients with drug-induced erythroderma in hospitalized patients is complex and the co-infection rate is high. The use of modified SCORTEN score may objectively and accurately assess the conditions, and the use of glucocorticoid combined with IVIG therapy may improve the prognosis.

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How Does SCORTEN Score?

Cited by 22 publications

References 9 publications

Accuracy of SCORTEN to predict the prognosis of Stevens‐Johnson syndrome/toxic epidermal necrolysis: a systematic review and meta‐analysis

Accuracy of SCORTEN to predict the prognosis of Stevens‐Johnson syndrome/toxic epidermal necrolysis: a systematic review and meta‐analysis

Accuracy of SCORTEN and ABCD‐10 to predict mortality and the influence of renal function in Stevens–Johnson syndrome/toxic epidermal necrolysis

Drug-induced erythroderma in patients with acquired immunodeficiency syndrome

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