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SCORTEN: does it need modification?

S S Vaishampayan1, A L Das, R Verma

  • 1Department of Dermatology, Armed Forces Medical College and Command Hospital (SC), Pune, Maharashtra, India. sanjeevssv1@yahoo.co.in

Indian Journal of Dermatology, Venereology and Leprology
|January 12, 2008
PubMed
Summary
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The SCORTEN score helps predict mortality in Toxic Epidermal Necrolysis (TEN) cases. Daily or alternate-day assessments of SCORTEN may improve mortality prediction in TEN patients.

Area of Science:

  • Dermatology
  • Clinical Medicine
  • Pharmacovigilance

Background:

  • Toxic Epidermal Necrolysis (TEN) is a severe, drug-induced condition with high mortality (15-60%).
  • The SCORTEN score was developed to predict mortality in TEN patients upon admission.
  • SCORTEN uses seven variables assessed within the first 24 hours, with scores from 1-7 correlating to mortality probabilities from 0.03 to 0.90.

Purpose of the Study:

  • To prospectively evaluate the efficacy of the SCORTEN score in predicting mortality among TEN patients during management.
  • To analyze the predictive accuracy of SCORTEN at different time points during hospitalization.

Main Methods:

  • Prospective study involving TEN cases reporting for management.
  • SCORTEN score calculation on day one and day five post-admission.

Related Experiment Videos

  • Comparison of SCORTEN predictions with actual patient outcomes.

    • Main Results:

    • Ten drug-induced TEN cases were treated, with ages ranging from 3 to 70 years and Body Surface Area (BSA) involvement from 10% to 95%.
    • Three patients (30%) died during the study period.
    • SCORTEN analysis showed variations from original studies; daily/alternate-day assessments appeared to be a better predictor of mortality.

    Conclusions:

    • Body Surface Area (BSA) involvement and patient age may require increased weighting in SCORTEN calculations.
    • Additional factors like malignancy, tuberculosis, and pre-existing diabetes should be considered for improved mortality prediction in TEN.