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396 Risk Factors Associated to Mortality in Mmexican Children with Stevens-Johnson Sndrome/Toxic Epidermal Necrolysis
BACKGROUND AND OBJECTIVE: Identify risk factors associated to mortality in Mexican children with Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis. METHODS: Cross-sectional analytical study. We reviewed the medical records of patients with hospitalization and primary diagnosis of Stevens-Johnson s...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
World Allergy Organization Journal
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3513109/ http://dx.doi.org/10.1097/01.WOX.0000412159.16865.f9 |
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author | Hernandez-Mondragon, Luis Octavio del Rio, Blanca Partida-Gaytan, Armando Almeida-Gutierrez, Eduardo Rosas-Vargas, Miguel Angel |
author_facet | Hernandez-Mondragon, Luis Octavio del Rio, Blanca Partida-Gaytan, Armando Almeida-Gutierrez, Eduardo Rosas-Vargas, Miguel Angel |
author_sort | Hernandez-Mondragon, Luis Octavio |
collection | PubMed |
description | BACKGROUND AND OBJECTIVE: Identify risk factors associated to mortality in Mexican children with Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis. METHODS: Cross-sectional analytical study. We reviewed the medical records of patients with hospitalization and primary diagnosis of Stevens-Johnson syndrome (SJS) or Toxic Epidermal Necrolysis (TEN) from January 1995 to May 2011. Our study variables have been previously described. We describe median (interquartilar range: IR) and percentage. Exact Fisher test, Mann Withney U and binary logistic regression were used. RESULTS: We obtained 51 medical records: 24 male (47.1%), 27 female (53%). Median age was 5 years (IR 2–8). Thirty eight (76%) corresponded to SJS, four (7.8%) to SJS-TEN overposition and nine (15.7%) to TEN. Mortality was seen in 9 patients (17.6%, 6 male [66.8%] and 3 female [33.3%], P > 0.05). Twenty two cases (43%) were attributed to anticonvulsive drugs, twenty (39%) to antibiotics, two (4%) to non-steroid anti-inflammatory drugs, two (4%) to infection, one (2%) to chemotherapeutic drugs, and in two (4%) no trigger factor was identified. Risk factors associated to mortality were: denudation of >30% Body Surface Area (BSA) (7.1% vs 55.6% P < 0.001), concomitant malignancy (0% vs 22.2% P < 0.028), moderate leucopenia (<1,000 cells/mL) (0% vs 33.3%, P < 0.001), leucocytosis (>20,000 cells/mL) (7.3% vs 22.2%, P < 0.001), hypokalemia (<3.5 mEq/L) (5.6% vs 33.3%, P < 0.011), hyperkalemia (>5.0 mEq/L) (5.6% vs 22.2%, P < 0.011). Total bilirrubin concentration >3.6 mg/dL has tendency to associate with mortality, P = 0.08. Six patients (11.7%) were treated with steroids, fifteen (29.4%) with IV human immunoglobulin and one (1.9%) with both drugs, no statistical difference was observed, though the steroid-treated group showed a tendency towards mortality increase. Some variables were not able to analyze due incomplete medical records. CONCLUSIONS: Risk factors associated to mortality in patients with SSJ/TEN identified in this study are: skin denudation >30% BSA, concomitant malignancy, leucopenia, leukocytosis, hypokalemia and hyperkalemia. Total bilirrubin concentration >3.6 mg/dL has tendency to associate with mortality, although not statistically significant. |
format | Online Article Text |
id | pubmed-3513109 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | World Allergy Organization Journal |
record_format | MEDLINE/PubMed |
spelling | pubmed-35131092012-12-21 396 Risk Factors Associated to Mortality in Mmexican Children with Stevens-Johnson Sndrome/Toxic Epidermal Necrolysis Hernandez-Mondragon, Luis Octavio del Rio, Blanca Partida-Gaytan, Armando Almeida-Gutierrez, Eduardo Rosas-Vargas, Miguel Angel World Allergy Organ J Abstracts of the XXII World Allergy Congress BACKGROUND AND OBJECTIVE: Identify risk factors associated to mortality in Mexican children with Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis. METHODS: Cross-sectional analytical study. We reviewed the medical records of patients with hospitalization and primary diagnosis of Stevens-Johnson syndrome (SJS) or Toxic Epidermal Necrolysis (TEN) from January 1995 to May 2011. Our study variables have been previously described. We describe median (interquartilar range: IR) and percentage. Exact Fisher test, Mann Withney U and binary logistic regression were used. RESULTS: We obtained 51 medical records: 24 male (47.1%), 27 female (53%). Median age was 5 years (IR 2–8). Thirty eight (76%) corresponded to SJS, four (7.8%) to SJS-TEN overposition and nine (15.7%) to TEN. Mortality was seen in 9 patients (17.6%, 6 male [66.8%] and 3 female [33.3%], P > 0.05). Twenty two cases (43%) were attributed to anticonvulsive drugs, twenty (39%) to antibiotics, two (4%) to non-steroid anti-inflammatory drugs, two (4%) to infection, one (2%) to chemotherapeutic drugs, and in two (4%) no trigger factor was identified. Risk factors associated to mortality were: denudation of >30% Body Surface Area (BSA) (7.1% vs 55.6% P < 0.001), concomitant malignancy (0% vs 22.2% P < 0.028), moderate leucopenia (<1,000 cells/mL) (0% vs 33.3%, P < 0.001), leucocytosis (>20,000 cells/mL) (7.3% vs 22.2%, P < 0.001), hypokalemia (<3.5 mEq/L) (5.6% vs 33.3%, P < 0.011), hyperkalemia (>5.0 mEq/L) (5.6% vs 22.2%, P < 0.011). Total bilirrubin concentration >3.6 mg/dL has tendency to associate with mortality, P = 0.08. Six patients (11.7%) were treated with steroids, fifteen (29.4%) with IV human immunoglobulin and one (1.9%) with both drugs, no statistical difference was observed, though the steroid-treated group showed a tendency towards mortality increase. Some variables were not able to analyze due incomplete medical records. CONCLUSIONS: Risk factors associated to mortality in patients with SSJ/TEN identified in this study are: skin denudation >30% BSA, concomitant malignancy, leucopenia, leukocytosis, hypokalemia and hyperkalemia. Total bilirrubin concentration >3.6 mg/dL has tendency to associate with mortality, although not statistically significant. World Allergy Organization Journal 2012-02-17 /pmc/articles/PMC3513109/ http://dx.doi.org/10.1097/01.WOX.0000412159.16865.f9 Text en Copyright © 2012 by World Allergy Organization |
spellingShingle | Abstracts of the XXII World Allergy Congress Hernandez-Mondragon, Luis Octavio del Rio, Blanca Partida-Gaytan, Armando Almeida-Gutierrez, Eduardo Rosas-Vargas, Miguel Angel 396 Risk Factors Associated to Mortality in Mmexican Children with Stevens-Johnson Sndrome/Toxic Epidermal Necrolysis |
title | 396 Risk Factors Associated to Mortality in Mmexican Children with Stevens-Johnson Sndrome/Toxic Epidermal Necrolysis |
title_full | 396 Risk Factors Associated to Mortality in Mmexican Children with Stevens-Johnson Sndrome/Toxic Epidermal Necrolysis |
title_fullStr | 396 Risk Factors Associated to Mortality in Mmexican Children with Stevens-Johnson Sndrome/Toxic Epidermal Necrolysis |
title_full_unstemmed | 396 Risk Factors Associated to Mortality in Mmexican Children with Stevens-Johnson Sndrome/Toxic Epidermal Necrolysis |
title_short | 396 Risk Factors Associated to Mortality in Mmexican Children with Stevens-Johnson Sndrome/Toxic Epidermal Necrolysis |
title_sort | 396 risk factors associated to mortality in mmexican children with stevens-johnson sndrome/toxic epidermal necrolysis |
topic | Abstracts of the XXII World Allergy Congress |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3513109/ http://dx.doi.org/10.1097/01.WOX.0000412159.16865.f9 |
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