The influence of acute kidney injury on the outcome of Stevens–Johnson syndrome and toxic epidermal necrolysis: The prognostic value of KDIGO staging

Lee, Tao Han; Lee, Cheng‐Chia; Ng, Chip-Jin; Chang, Ming-Yang; Chang, Su-Wei; Fan, Pei‐Chun; Chung, Wen‐Hung; Tian, Ya-Chung; Chen, Yung‐Chang; Chang, Chih‐Hsiang

doi:10.1371/journal.pone.0203642

Cited by 19 publications

(21 citation statements)

References 33 publications

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“…The majority of these studies were performed using the RIFLE (Risk, Injury, Failure, Lost, End-stage kidney disease) or AKIN (Acute Kidney Injury Network) criteria for staging of AKI [13][14][15]. AKI was classified by using the KDIGO criteria in current studies [16][17][18]. We preferred to use KDIGO criteria which is more up to date.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of prognosis and nephrotoxicity in patients treated with colistin in intensive care unit

et al. 2020

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Introduction: Nephrotoxicity is the most important adverse effect of colistin therapy. We investigated the frequency of nephrotoxicity, risk factors related to nephrotoxicity, and its relationship with mortality in patients who received intravenous colistin in intensive care units (ICUs). Materials and methods: We retrospectively reviewed the data of patients who received intravenous colistin in ICUs between 2011 and 2017. Acute kidney injury (AKI) diagnosis and staging were made based on the Kidney Disease Improving Global Outcome criteria. Results: There were 149 patients included in the study with 61% being male. The mean age was 58.7 ± 20.3 years. AKI was detected in 96 (64.4%) patients. There were 25 patients with AKI stage 1 (16.8%) and 71 patients with AKI stage 2 or 3 (47.7%). Advanced age (65.0 vs. 47.4 years; p < .001), diabetes mellitus (p < .001), heart failure (p ¼ .01), high APACHE II score (31.7 vs. 28.08, p ¼ .019), and inotrope usage (p ¼ .01) were found as risk factors for AKI. The 14-day mortality rate was higher in the AKI group (p ¼ .027). Discussion: Higher AKI and mortality rates are observed in patients with diabetes, heart failure, advanced age and the hemodynamically impaired. However, it is a fact that there are no alternative therapies other than colistin in the treatment of multidrug-resistant Gram-negative bacterial infections. Therefore, the development of AKI in this patient group should not be considered a sufficient reason for discontinuing colistin treatment. Understanding the risk factors in this potential nephrotoxic treatment can provide a more careful patient follow-up.

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Section: Discussionmentioning

confidence: 99%

Evaluation of prognosis and nephrotoxicity in patients treated with colistin in intensive care unit

et al. 2020

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“…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%

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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“…Kidney disorders are also the common complicating conditions which may be observed in patients with SJS. 20 The morbidity and mortality rates in people with hypersensitivity, in this case SJS, are high, so that the alignment of collaborative team consisting of multidisciplinary dental and medical experts is needed. Based on this case report, the role of oral medicine specialist is very important as part of the management team for SJS patient.…”

Section: Resultsmentioning

confidence: 99%

The Important Role of Oral Medicine Specialist in Management of Stevens-Johnson Syndrome Patient

Fitriasari¹,

Nurtito²,

Nur’aeny³

et al. 2020

Dentino

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Introduction: Stevens-Johnson Syndrome (SJS) is an acute hypersensitivity reaction that manifests on the skin, oral mucosa, ocular, gastrointestinal, genital and anal area. It is also potentially life-threatening in concern of dehydration and infection. Oral mucosal lesions due to SJS resulted in a significant decrease of patient’s quality of life. When the oral mucosa involved, the intake of nutrients and fluids is disrupted contributing to electrolyte imbalance that aggravates dehydration. Moreover, oral mucosal lesions have become an entry point for infection. Purpose: This case report describes the important role of oral medicine specialists in the management of oral mucosal lesions in SJS patient. Review: A 26-year-old female patient was referred from the Department of Dermatology and Venereology with a diagnosis of SJS et causa suspected paracetamol and/or amoxycillin. The complaints comprised of pain on the lips and oral cavity, difficulty in mouth opening, and pain when swallowing. The management for oral lesions included: history taking, external and intra oral examinations, dexamethasone mouthwash, nystatin oral suspension, and sodium chloride (NaCl) 0.9% solution. The patient showed improvement in oral mucosal lesions within 3 weeks of treatment that was provided by oral medicine specialist and medical team collaboration. Conclusion: Based on this case report, the role of oral medicine specialist is very important as part of the management team for SJS patient. Oral medicine specialist can reduce morbidity that results from oral mucosal involvement. Collaboration with oral medicine specialist since the beginning of treatment is the key to success in SJS management. Keywords: Oral medicine specialist, Oral mucosal lesion, Stevens-Johnson Syndrome.

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The influence of acute kidney injury on the outcome of Stevens–Johnson syndrome and toxic epidermal necrolysis: The prognostic value of KDIGO staging

Cited by 19 publications

References 33 publications

Evaluation of prognosis and nephrotoxicity in patients treated with colistin in intensive care unit

Evaluation of prognosis and nephrotoxicity in patients treated with colistin in intensive care unit

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

The Important Role of Oral Medicine Specialist in Management of Stevens-Johnson Syndrome Patient

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