{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T09:02:49Z","timestamp":1784192569538,"version":"3.55.0"},"reference-count":27,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2017,11,16]],"date-time":"2017-11-16T00:00:00Z","timestamp":1510790400000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["K12 HS023011"],"award-info":[{"award-number":["K12 HS023011"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001582","name":"Dermatology Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001582","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microbiology and Immunology"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:label\/><jats:p>Toxic Shock Syndrome (TSS), a superantigen\u2010mediated illness, is characterized by rash, hypotension and multi\u2010organ dysfunction. Predictors of TSS and related morbidity and mortality are poorly defined. In this study, data on 61,959,084 hospitalizations from the 2003\u20132012 Nationwide Inpatient Sample, a 20% stratified sample of US hospitalizations, were analyzed and ICD\u20109\u2010CM coding used to identify 4491 hospitalizations with a diagnosis of TSS. Incidence, in\u2010hospital mortality rate, comorbidities, length of stay and costs of care attributable to TSS were determined. In multivariate survey logistic regression models, TSS was associated with female sex (adjusted odds ratio [95% confidence interval], 1.54 [1.48\u20131.60]), younger age (0\u201317 years, 2.17 [2.06\u20132.29]; 40\u201359: 0.53 [0.50\u20130.56]; 60\u201379: 0.28 [0.26\u20130.30]; 80+: 0.13 [0.11\u20130.14] compared with 18\u201339) and race\/ethnicity (black, 0.63 [0.59\u20130.67]; Hispanic: 0.60 [0.56\u20130.64]; Asian, 1.11 [1.00\u20131.11]; and other, 0.83 [0.75\u20130.92] compared with white). Patients with TSS had a three\u2010fold greater cost of care (mean: $36,656\u2009\u00b1\u2009942) and length of stay (LOS) (mean: 10.65\u2009\u00b1\u20090.23 days) than patients without TSS. Shared predictors of increased LOS and costs in patients with TSS were male sex; age 40\u201379 years; Black, Hispanic, Asian and other race\/ethnicity; and more than one chronic condition. Predictors of in\u2010hospital mortality included respiratory failure (13.66 [11.37\u201316.43]), liver disease\/failure (3.36 [2.59\u20134.34]), chickenpox (91.26 [27.74\u2013300.25]), coagulopathy (2.14 [1.85\u20132.48]), and higher age. In conclusion, there are significant racial\/ethnic, socioeconomic, and comorbid disparities in the incidence and mortality of TSS in adults and children in the USA.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1348-0421.12539","type":"journal-article","created":{"date-parts":[[2017,9,11]],"date-time":"2017-09-11T15:28:26Z","timestamp":1505143706000},"page":"463-473","source":"Crossref","is-referenced-by-count":24,"title":["Prevalence, comorbidities and mortality of toxic shock syndrome in children and adults in the USA"],"prefix":"10.1111","volume":"61","author":[{"given":"Mark A.","family":"Strom","sequence":"first","affiliation":[{"name":"Department of Dermatology Feinberg School of Medicine at Northwestern University 676 N Saint Clair, St Suite 1600 Chicago IL 60611 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek Y.","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Dermatology Feinberg School of Medicine at Northwestern University 676 N Saint Clair, St Suite 1600 Chicago IL 60611 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan I.","family":"Silverberg","sequence":"additional","affiliation":[{"name":"Departments of Dermatology Preventive Medicine and Medical Social Sciences Feinberg School of Medicine at Northwestern University 676 N Saint Clair, St Suite 1600 Chicago IL 60611 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,11,16]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(09)70066-0"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(78)92274-2"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198907063210101"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.micro.55.1.77"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0022997"},{"key":"e_1_2_8_7_1","doi-asserted-by":"crossref","first-page":"1855","DOI":"10.3201\/eid1011.121547","article-title":"Infectious shock and toxic shock syndrome diagnoses in hospitals, Colorado, USA","volume":"19","author":"Smit M.A.","year":"2013","journal-title":"Emerg Infect 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