title: Late outcomes in adult survivors of toxic epidermal necrolysis after treatment in a burn center.
abstract: Despite improved survival after burn center treatment for patients with toxic epidermal necrolysis (TEN), little is known about the overall long-term outcomes in these patients. In this work we sought to analyze late outcomes in survivors of TEN who were treated in our burn center. Subjects completed a questionnaire that included the RAND 36-Item Health Survey (SF-36) and the Dermatology Life Quality Index. Subjects were examined, when possible, and completed the Functional Independence Measure. Scores on the SF-36 were compared with age- and sex-matched National normative data. All results are presented as the mean +/- SD. Of 35 adults admitted with TEN between January 1, 1995, and January 6, 2003, 10 have died in hospital, 4 have died since discharge, and 8 have been lost to follow-up, leaving a study population of 13 subjects (age 45 +/- 18 years with initial %TBSA involvement 65 +/- 29). Follow-up occurred at 38 +/- 27 months after discharge. The most common ophthalmic problems were chronic photosensitivity (54%) and dry eyes (31%). The Dermatology Life Quality Index (maximum-worst score = 30) was 9 +/- 10. SF-36 scores were significantly lower than in the age- and sex-matched normal population across all domains except mental health. The Functional Independence Measure score (maximum-best score = 126) was 123 +/- 4. Survivors of TEN demonstrate a high level of independent function in activities of daily living, but numerous complications of TEN significantly impair their overall quality of life, emphasizing the need for long-term follow-up.
authors.affiliation: Ross Tilley Burn Center, Sunnybrook and Women's College Health Sciences Center, 1075 Bayview Avenue, Toronto, Ontario, Canada M4N 3M5.
authors.forename: Julia
authors.initials: J
authors.lastname: Haber
authors.forename: Wilma
authors.initials: W
authors.lastname: Hopman
authors.forename: Manuel
authors.initials: M
authors.lastname: Gomez
authors.forename: Robert
authors.initials: R
authors.lastname: Cartotto
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D002053:Burn Units; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012720:Severity of Illness Index; D013262:Stevens-Johnson Syndrome / Q000150:complications / Q000473:pathology* / Q000628:therapy*; D016896:Treatment Outcome