SCORTEN Accurately Predicts Mortality Among Toxic Epidermal Necrolysis Patients Treated in a Burn Center

Abstract

SCORTEN is a scoring system used to predict mortality in toxic epidermal necrolysis (TEN) patients. The accuracy of SCORTEN among TEN patients treated in burn centers has not been established. The purpose of this study was to assess the discriminative power and calibration of SCORTEN among TEN patients treated at an adult regional burn center. Retrospective analysis of a consecutive series of TEN patients was used to compare actual mortality with that predicted by SCORTEN. A standardized mortality ratio was obtained to compare the actual number of deaths to the predicted number based on SCORTEN. Discrimination was measured using the area under the receiver operator characteristic curve, and model fit (calibration) was measured using the Hosmer-Lemeshow goodness-of-fit statistic. A total of 61 adult patients were analyzed. The actual overall mortality rate of 29.5% was not significantly different than the mortality rate of 25.2% predicted by SCORTEN (standardized mortality ratio, 1.17; 95% confidence intervals, 0.695-1.853; P = .08). The area under the receiver operator characteristic curve was 0.82 and the Hosmer-Lemeshow statistic was 1.381 (P = .710). SCORTEN is an accurate scoring system for estimation of mortality among TEN patients treated in a burn center setting.