Identification of Stevens-Johnson syndrome and toxic epidermal necrolysis in electronic health record databases

Davis, Robert L.; Gallagher, M. J.; Asgari, Maryam M.; Eide, Melody J.; Margolis, David J.; Macy, Eric; Burmester, James K.; Selvam, Nandini; Boscarino, Joseph A.; Cromwell, Lee F.; Feigelson, Heather Spencer; Kuntz, Jennifer L; Pawloski, Pamala A.; Penfold, Robert B.; Raebel, Marsha A.; Sridhar, Gayathri; Wu, Ann Chen; Grenade, Lois A La; Pacanowski, Michael; Pinheiro, Simone P.

doi:10.1002/pds.3778

Cited by 43 publications

(40 citation statements)

References 20 publications

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“…Therefore, we limited our study to no earlier than 2009. Since the reclassification, the newer ICD‐9 codes used in this study have been shown to better reflect SJS and TEN cases than codes before 2008 …”

Section: Methodsmentioning

confidence: 94%

“…Individuals younger than 18 years old admitted to one of the hospitals in the 2009 or 2012 KID database with a primary discharge diagnosis of 695.13 (SJS), 695.14 (SJS/TEN overlap syndrome), or 695.15 (TEN) and a LOS of longer than 3 days were included . Incorporating LOS can improve retrospective identification of SJS/TEN cases . A LOS of longer than 3 days was chosen based on previously published studies .…”

Section: Methodsmentioning

confidence: 99%

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Incidence, outcomes, and resource use in children with Stevens‐Johnson syndrome and toxic epidermal necrolysis

Antoon

Goldman

Lee

et al. 2018

Pediatric Dermatology

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Section: Methodsmentioning

confidence: 94%

Section: Methodsmentioning

confidence: 99%

Incidence, outcomes, and resource use in children with Stevens‐Johnson syndrome and toxic epidermal necrolysis

Antoon

Goldman

Lee

et al. 2018

Pediatric Dermatology

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show abstract

“…Based on a previously validated algorithm, patients who had a LOS <3 days were excluded to improve positive predictive value of diagnostic codes 13 . Patients with a concomitant diagnosis of any other bullous dermatosis were excluded (ICD-9-CM: 694.0-694.9), since certain bullous dermatoses have rarely been reported to masquerade as TEN 14 .…”

Section: Exposures and Outcomesmentioning

confidence: 99%

Pediatric Stevens-Johnson syndrome and toxic epidermal necrolysis in the United States

Hsu

Brieva

Silverberg

et al. 2017

Journal of the American Academy of Dermatology

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“…Chart review was then performed to verify that the clinical symptoms were compatible with the coded diagnosis and to identify the specific agent most likely associated with the adverse reaction noted. 8 New C difficile infections within 90 days of delivery were identified by either a new report of C difficile coded (ICD-9 Code 008.45) or a positive microbiology culture or polymerase chain reaction for C difficile within 90 days of delivery.…”

Section: Original Research and Contributionsmentioning

confidence: 99%

Morbidity in Pregnant Women Associated with Unverified Penicillin Allergies, Antibiotic Use, and Group B Streptococcus Infections

Desai

Kaplan

Chen³

et al. 2017

TPJ

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Context:The morbidity potentially associated with unverified penicillin allergy in pregnant women, with and without group B streptococcus (GBS) infections, is unknown. Penicillin allergy testing is safe during pregnancy but is done infrequently.Objective: To determine morbidity associated with antibiotic use in a large cohort of pregnant women, with and without an unverified history of penicillin allergy, and with and without GBS.Design: Retrospective. All pregnant women who delivered live infants in Kaiser Permanente Southern California between January 1, 2009, and December 31, 2014, were identified.Main Outcome Measures: Penicillin allergy status at delivery, delivery method, maternal and infant hospital utilization, peripartum antibiotic exposures, new antibioticassociated adverse drug reactions, and new Clostridium difficile infections.Results: There were 170,379 unique women who had 201,316 pregnancies during the study period. There were 16,084 pregnancies in women with an active, but unverified, penicillin allergy at delivery. There were 42,524 pregnancies in GBS-positive women, and 3500 also had a penicillin allergy. Women with a penicillin allergy, with or without GBS, had significantly (about 10%) higher cesarean section rates and spent significantly more (about 0.1) days in the hospital after delivery. Among GBS-positive women, those with an unverified penicillin allergy were exposed to significantly more cefazolin, clindamycin, vancomycin, and gentamicin and had significantly higher rates of adverse drug reactions associated with all antibiotic use.Conclusions: Unverified penicillin allergy is associated with more hospital utilization and additional morbidity. Penicillin allergy testing of pregnant women with a history of penicillin allergy may help reduce these unwanted outcomes.

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Identification of Stevens-Johnson syndrome and toxic epidermal necrolysis in electronic health record databases

Abstract: Newer ICD-9 codes, along with length of hospitalization, identified patients with a high likelihood of SJS/TEN. This is important for identification of subjects for future pharmacogenomics studies.

Cited by 43 publications

References 20 publications

Incidence, outcomes, and resource use in children with Stevens‐Johnson syndrome and toxic epidermal necrolysis

Incidence, outcomes, and resource use in children with Stevens‐Johnson syndrome and toxic epidermal necrolysis

Pediatric Stevens-Johnson syndrome and toxic epidermal necrolysis in the United States

Morbidity in Pregnant Women Associated with Unverified Penicillin Allergies, Antibiotic Use, and Group B Streptococcus Infections

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