Noe et al reported the ABCD-10 score for evaluating a hospitalized patient with Stevens-Johnson Syndrome (SJS) or Toxic Epidermal Necrolysis (TEN). This can help to identify a patient who may benefit from more aggressive management. The authors are from multiple institutions from around the United States.
Patient selection: Stevens-Johnson Syndrome (SJS) or Toxic Epidermal Necrolysis (TEN)
Outcome: in-hospital mortality
ABCD-10 is an acronym for age, bicarbonate, cancer, dialysis and 10% BSA.
Parameters:
(1) age in years
(2) percent of body surface area with epidermal detachment
(3) serum bicarbonate in mmol/L
(4) active or ongoing cancer
(5) dialysis prior to admission
|
Parameter
|
Finding
|
Points
|
|
age
|
< 50 years
|
0
|
|
|
>= 50
|
1
|
|
percent BSA
|
<= 10%
|
0
|
|
|
> 10%
|
1
|
|
serum bicarbonate
|
>= 20 mmol/L
|
0
|
|
|
< 20 mmol/L
|
1
|
|
cancer
|
no
|
0
|
|
|
yes
|
2
|
|
dialysis
|
no
|
0
|
|
|
yes
|
3
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 8
• The higher the score the greater the risk of in-hospital mortality.
value of X =
= (0.898 * (score)) - 3.764
probability of in-hospital death =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve is 0.82
