Guzman et al reported risk factors for 30-day readmission for a 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 Albert Einstein College of Medicine, Johns Hopkins Univresity and Ohio State University.
Patient selection: Stevens-Johnson Syndrome or Toxic Epidermal Necrolysis
Rate of readmission: 10%
Reasons for readmission include:
(1) systemic infection
(2) cutaneous infection
(3) relapse of SJS or TEN
(4) other dermatologic condition
(5) organ dysfunction (GI, cardiac, pulmonary, renal, endocrine, neurologic, other)
Risk factors for readmission:
(1) age from 45 to 64 years (OR 1.9)
(2) Medicaid insurance (OR 1.8)
(3) non-Metropolitanhospital admission (OR 1.7)
(4) comorbid conditions
Comorbid conditions include:
(1) HIV/AIDS (OR 2.5)
(2) collagen vascular disease (OR 2.4)
(3) metastatic cancer (OR 2.2)
The risk of readmission increases with the number of risk factors and comorbid conditions