{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,5]],"date-time":"2025-10-05T12:29:55Z","timestamp":1759667395438},"reference-count":30,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2015,9,28]],"date-time":"2015-09-28T00:00:00Z","timestamp":1443398400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Recently, the importance of reporting the results and principles of management in Toxic epidermal necrolysis (<jats:styled-content style=\"fixed-case\">TEN<\/jats:styled-content>) patients was underscored. Treatment of<jats:styled-content style=\"fixed-case\">TEN<\/jats:styled-content>focuses on supportive care, often provided in a burn centre setting. Mortality in<jats:styled-content style=\"fixed-case\">TEN<\/jats:styled-content>patients can be high; the<jats:styled-content style=\"fixed-case\">SCORTEN<\/jats:styled-content>score is a scoring system that predicts mortality in patients with<jats:styled-content style=\"fixed-case\">TEN<\/jats:styled-content>. The predictive value of the<jats:styled-content style=\"fixed-case\">SCORTEN<\/jats:styled-content>score in our setting is unclear, as are the treatment costs of<jats:styled-content style=\"fixed-case\">TEN<\/jats:styled-content>patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To describe patient characteristics, treatment, outcome and direct medical costs of patients with<jats:styled-content style=\"fixed-case\">TEN<\/jats:styled-content>treated in one Dutch burn centre in a 27\u2010year period. In addition, determinants of mortality and the predictive value of the<jats:styled-content style=\"fixed-case\">SCORTEN<\/jats:styled-content>score were assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective study was conducted in all patients with<jats:styled-content style=\"fixed-case\">TEN<\/jats:styled-content>(including Stevens\u2013Johnson syndrome (<jats:styled-content style=\"fixed-case\">SJS<\/jats:styled-content>) and overlap<jats:styled-content style=\"fixed-case\">SJS<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">TEN<\/jats:styled-content>) admitted to the burn centre Rotterdam between January 1987 and December 2013. The discriminative value of the<jats:styled-content style=\"fixed-case\">SCORTEN<\/jats:styled-content>score was assessed by receiver\u2010operator characteristics curve analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 63 patients were admitted in 27\u2010year period. Overall mortality was 39.7%, mortality in<jats:styled-content style=\"fixed-case\">TEN<\/jats:styled-content>patients (&gt;30%<jats:styled-content style=\"fixed-case\">TBSA<\/jats:styled-content>) was 37.1%. A higher age (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>= 1.04, 95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 1.02\u20131.07) and comorbidity (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>= 4.25, 95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 1.2\u201314.7) were associated with mortality. The discriminative value of the<jats:styled-content style=\"fixed-case\">SCORTEN<\/jats:styled-content>prediction model in our population was limited (<jats:styled-content style=\"fixed-case\">AUC<\/jats:styled-content>=0.72, 95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0.57\u20130.86). The mean direct medical hospital\u2010based costs was \u20ac41.361.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Toxic epidermal necrolysis is a severe adverse drug reaction, with a high mortality. Elderly patients and patients with comorbidity, especially circulatory comorbidity, have a relatively high risk of decease. The<jats:styled-content style=\"fixed-case\">SCORTEN<\/jats:styled-content>score, a frequently used prediction model in patients with<jats:styled-content style=\"fixed-case\">TEN<\/jats:styled-content>, underestimated the mortality in our study, mainly due to limited availability in patients with a good prognosis. The treatment of patient with<jats:styled-content style=\"fixed-case\">TEN<\/jats:styled-content>is associated with high direct medical hospital\u2010based costs, also compared to burn patients in general.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.13352","type":"journal-article","created":{"date-parts":[[2015,9,29]],"date-time":"2015-09-29T00:58:56Z","timestamp":1443488336000},"page":"2444-2450","source":"Crossref","is-referenced-by-count":21,"title":["Epidemiology and costs of patients with toxic epidermal necrolysis: a 27\u2010year retrospective study"],"prefix":"10.1111","volume":"29","author":[{"given":"I.M.M.H.","family":"Oen","sequence":"first","affiliation":[{"name":"Burn Centre Maasstad Hospital Rotterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.H.","family":"van der Vlies","sequence":"additional","affiliation":[{"name":"Burn Centre Maasstad Hospital Rotterdam the Netherlands"},{"name":"Department of Surgery Maasstad Hospital Rotterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y.W.F.","family":"Roeleveld","sequence":"additional","affiliation":[{"name":"Burn Centre Maasstad Hospital Rotterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Dokter","sequence":"additional","affiliation":[{"name":"Burn Centre Maasstad Hospital Rotterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.J.","family":"Hop","sequence":"additional","affiliation":[{"name":"Association of Dutch Burn Centres Burn Centre Maasstad Hospital Rotterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.E.","family":"van Baar","sequence":"additional","affiliation":[{"name":"Association of Dutch Burn Centres Burn Centre Maasstad Hospital Rotterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,9,28]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.1956.tb12766.x"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/1750-1172-5-39"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1586\/eci.11.66"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199512143332404"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0305-4179(93)90063-E"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004630-200203000-00004"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.burns.2014.02.006"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/jid.2012.510"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1747.2000.00061.x"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004630-200021030-00004"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.BCR.0000216532.71360.9B"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2006.02082.x"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/wrr.12189"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-198611000-00001"},{"key":"e_1_2_6_16_1","first-page":"340","article-title":"Toxic epidermal necrolysis: a systemic and dermatologic disorder best treated with standard treatment protocols in burn intensive care units without the prolonged use of corticosteroids","volume":"180","author":"Herndon DN","year":"1995","journal-title":"J Am Coll Surg"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2007.08.039"},{"key":"e_1_2_6_18_1","doi-asserted-by":"crossref","DOI":"10.1093\/oso\/9780195108248.001.0001","volume-title":"Cost\u2010effectiveness in health and medicine","author":"Gold MR","year":"1996"},{"key":"e_1_2_6_19_1","unstructured":"HopMJ WijnenBFM NieuwenhuisMK vanLoey MiddelkoopE PolinderS vanBaarME and the Dutch Burn Repository Group. 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