SCORTEN scale

SCORTEN Scale is a medical tool used to predict the mortality of patients with Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN). It was developed by Bastuji-Garin et al. in 2000 and has since been validated in multiple studies.

Overview

The SCORTEN scale, also known as the Severity-of-Illness Score for Toxic Epidermal Necrolysis, is a scoring system that uses seven independent risk factors to predict the mortality of patients with SJS and TEN. Each risk factor is assigned one point, and the total score is used to predict the patient's risk of death.

Risk Factors

The seven risk factors included in the SCORTEN scale are:

1. Age > 40 years
2. Presence of a malignancy
3. Heart rate > 120 bpm
4. Initial body surface area of epidermal detachment > 10%
5. Serum urea level > 28 mg/dL
6. Serum glucose level > 252 mg/dL
7. Serum bicarbonate level < 20 mEq/L

Scoring and Mortality Prediction

The total SCORTEN score is calculated by adding up the points for each risk factor present. The predicted mortality rates based on the SCORTEN score are as follows:

• Score 0-1: 3.2% mortality
• Score 2: 12.1% mortality
• Score 3: 35.3% mortality
• Score 4: 58.3% mortality
• Score 5: 90% mortality

Limitations

While the SCORTEN scale is a useful tool for predicting mortality in SJS and TEN patients, it does have some limitations. It does not take into account the patient's response to treatment, and it may not be accurate in all populations.

See Also

• Stevens-Johnson syndrome
• Toxic Epidermal Necrolysis
• Severity scoring systems in dermatology