Pediatric Stevens-Johnson syndrome and toxic epidermal necrolysis in the United States - 18/04/17
Abstract |
Background |
Little is known about the epidemiology of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) in children.
Objective |
We sought to determine the morbidity, mortality, and comorbid health conditions of SJS and TEN in US children.
Methods |
This was a cross-sectional study of the 2009 to 2012 Nationwide Inpatient Sample, which contains a representative 20% sample of all US hospitalizations. Sociodemographics, inflation-adjusted cost, length of stay, comorbidities, and mortality were analyzed using descriptive statistics and multivariate regression analyses.
Results |
The incidences of SJS, SJS-TEN, and TEN were a mean 5.3, 0.8, and 0.4 cases per million children per year in the US, respectively. Prolonged length of stay and higher costs of care (SJS: 9.4 ± 0.6 days, $24,947 ± $3171; SJS-TEN: 15.7 ± 1.5 days, $63,787 ± $8014; TEN: 20.4 ± 6.3 days, $102,243 ± $37,588) were observed compared with all other admissions (4.6 ± 0.1 days, $10,496 ± $424). Mortality was 0% for SJS, 4% for SJS-TEN, and 16% for TEN. In regression models, predictors of mortality included renal failure (adjusted OR [aOR] 300.28, 95% confidence interval [CI] 48.59->999.99), malignancy (aOR 54.33, 95% CI 9.40-314.22), septicemia (aOR 30.45, 95% CI 7.91-117.19), bacterial infection (aOR 20.38, 95% CI 5.44-76.36), and epilepsy (aOR 5.56, 95% CI 1.37-26.2).
Limitations |
Data regarding treatment were not available. Date of diagnosis of comorbidities was not present, precluding temporal analysis.
Conclusions |
Pediatric SJS/TEN poses a substantial health burden in the United States.
Le texte complet de cet article est disponible en PDF.Key words : burden of disease, children, epidemiology, hospitalization, pediatric, Stevens-Johnson syndrome, toxic epidermal necrolysis
Abbreviations used : AHRQ, aOR, BSA, CI, GVHD, ICD-9-CM, LOS, NIS, OR, SJS, TEN
Plan
| This publication was made possible with support from the Agency for Healthcare Research and Quality, grant number K12HS023011, the Dermatology Foundation. |
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| Conflicts of interest: None declared. |
Vol 76 - N° 5
P. 811 - mai 2017 Retour au numéro
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