Predictive value of a severity-of-illness score for toxic epidermal necrolysis (SCORTEN) factors for in-hospital mortality in Stevens–Johnson syndrome/toxic epidermal necrolysis

2026

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DOI 10.3389/fmed.2025.1735242
Data confidence 70 medium
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Abstract

Introduction: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening mucocutaneous reactions with high mortality. The A severity-of-illness score for toxic epidermal necrolysis (SCORTEN) scale remains the principal tool for early estimation of in-hospital death risk. The study was aimed to assess the predictive value of individual SCORTEN components for hospital mortality in a real-world Moscow cohort and to characterize demographic and etiologic factors associated with outcome. Methods: We retrospectively reviewed 150 adult patients (median age 50 years; IQR: 31-63; 59.3% female) admitted with SJS (45.3%) or TEN (54.7%) between 2019 and 2024. SCORTEN parameters were recorded within 24 h of admission. Univariate analyses (chi-square or Fisher's exact test) identified associations between each SCORTEN variable and in-hospital death. Kaplan-Meier survival curves and Cox proportional-hazards models quantified time-to-event outcomes and adjusted hazard ratios (HR). Results: = 0.04) remained independent predictors. Initial epidermal detachment, serum glucose, and age did not retain significance. Discussion: These findings support continued use of SCORTEN while highlighting the need to recalibrate or augment its parameters-particularly renal and oncologic variables-to improve risk stratification in current therapeutic contexts.