title: Comprehensive survival analysis of a cohort of patients with Stevens-Johnson syndrome and toxic epidermal necrolysis.
abstract: Stevens-Johnson syndrome and toxic epidermal necrolysis are severe cutaneous adverse reactions that are of major concern because of high mortality rates. On the basis of data collected in the RegiSCAR study, the aim was to assess risk factors (including modalities of patient management) for mortality, regardless of the cause, up to 1 year after the reaction. Within this cohort, the mortality rate was 23% (95% confidence interval (CI) 19-27%) at 6 weeks and 34% (95% CI 30-39%) at 1 year. Severity of reaction was a risk factor for mortality only in the first 90 days after onset, whereas serious comorbidities and age influenced mortality beyond 90 days and up to 1 year after onset of reaction. The risk of death for patients with identified drug cause was borderline lower than for patients with a reaction of unknown cause (hazard ratio 0.66, 95% CI 0.45-0.96). The study could not provide conclusive evidence regarding patient management. This large-scale population-based follow-up study of such patients confirmed high in-hospital mortality and revealed a remarkable number of deaths after discharge, which could mainly be attributed to severe comorbidities and older age, whereas the impact of severity of reaction on the risk of death was limited to the first few weeks.
authors: Institute of Medical Biometry and Medical Informatics, University Medical Center Freiburg, Freiburg, Germany. ps@imbi.uni-freiburg.de
authors: Peggy
authors: P
authors: Sekula
authors: Ariane
authors: A
authors: Dunant
authors: Maja
authors: M
authors: Mockenhaupt
authors: Luigi
authors: L
authors: Naldi
authors: Jan Nico
authors: JN
authors: Bouwes Bavinck
authors: Sima
authors: S
authors: Halevy
authors: Sylvia
authors: S
authors: Kardaun
authors: Alexis
authors: A
authors: Sidoroff
authors: Yvonne
authors: Y
authors: Liss
authors: Martin
authors: M
authors: Schumacher
authors: Jean-Claude
authors: JC
authors: Roujeau
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D012307:Risk Factors; D013262:Stevens-Johnson Syndrome / Q000401:mortality*; D015996:Survival Rate