Mối liên quan của thang điểm CRISTEN và công thức máu với mức độ nặng trong hội chứng Stevens – Johnson/hoại tử thượng bì nhiễm độc

Abstract

Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe mucocutaneous adverse reactions associated with substantial morbidity and mortality. The CRISTEN prognostic score, which incorporates 10 clinical criteria, together with complete blood count parameters, may provide a practical and cost-effective approach for early risk stratification and patient monitoring. This retrospective study was conducted using medical records of patients with SJS/TEN treated at the National Hospital of Dermatology and Venereology and the Center for Allergy and Clinical Immunology, Bach Mai Hospital, over a 3-year period from 2017 to 2019. The study aimed to evaluate the prognostic value of the CRISTEN score and complete blood count parameters in patients with SJS/TEN. A total of 76 patients were included, comprising 32 patients with SJS and 44 patients with TEN. Patients with TEN had significantly lower white blood cell (WBC) and neutrophil (NEU) counts than those with SJS (p = 0.003 and p = 0.019, respectively). Both SCORTEN and CRISTEN demonstrated good discriminatory performance for severe disease, with AUC values of 0.857 and 0.815, respectively. In multivariable linear regression analysis, the combined models including SCORTEN or CRISTEN together with lymphocyte and platelet counts were significantly associated with length of hospital stay, explaining 19.9% and 17.3% of its variability, respectively (R² = 0.199, p = 0.002 and R² = 0.173, p = 0.006). These findings suggest that SCORTEN, CRISTEN, and complete blood count parameters on the first day of admission may be useful for assessing the risk of severe disease and prolonged hospitalization in patients with SJS/TEN.