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Stevens-Johnson syndrome/toxic epidermal necrolysis and erythema multiforme drug-related hospitalisations in a national administrative database

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Resumo:BACKGROUND: Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) and erythema multiforme (EM) are immunologically-mediated dermatological disorders commonly triggered by drug exposure and/or other external agents. We aimed to characterise SJS/TEN- and EM-drug-related hospitalisations in a nationwide administrative database, focusing on demographic and clinical characteristics, and in the most frequently implicated drug classes. METHODS: We analysed all drug-related hospitalisations with associated diagnosis of SJS/TEN or EM in Portuguese hospitals between 2009 and 2014. We compared gender, age, comorbidities, length of stay, and in-hospital mortality and estimated the number of episodes per million packages sold of drug classes. Predictors of in-hospital mortality were investigated in both conditions by logistic regression. RESULTS: There were 132 SJS/TEN-related and 122 EM-related hospitalisations. Incidence and in-hospital mortality of SJS/TEN episodes (24.2%) were consistent with previous studies. HIV co-infection was more common among SJS/TEN hospitalisations (9 vs. 2% with EM; P = 0.009). Liver disease, advanced age, and a TEN diagnosis, were significantly associated with higher risk of mortality in patients with SJS/TEN. The highest numbers of SJS/TEN and EM episodes per million drug packages sold were observed for antivirals (8.7 and 1.5, respectively), antineoplastic/immunosuppressive drugs (5.6 and 3.9, respectively) and hypouricaemic drugs (5.0 and 2.4, respectively). CONCLUSIONS: SJS/TEN in-hospital mortality is high, and its risk factors include advanced age, liver disease, and TEN diagnosis. The drug classes most frequently associated with these conditions include antivirals, hypouricaemic drugs and antineoplastic/immunosuppressive drugs. Administrative databases seem useful in the study of SJS/TEN drug-related hospitalisations, yielding results consistent with previous studies and on a nationwide basis.
Autores principais:Sousa-Pinto, B
Outros Autores:Araújo, L; Freitas, A; Correia, O; Delgado, L
Assunto:Eritema Multiforme Síndrome de Stevens-Johnson Hospitalização Erythema Multiforme Stevens-Johnson Syndrome Hospitalization
Ano:2018
País:Portugal
Tipo de documento:artigo
Tipo de acesso:acesso aberto
Instituição associada:CUF
Idioma:inglês
Origem:Saúde - CUF
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author Sousa-Pinto, B
author2 Araújo, L
Freitas, A
Correia, O
Delgado, L
author2_role author
author
author
author
author_facet Sousa-Pinto, B
Araújo, L
Freitas, A
Correia, O
Delgado, L
author_role author
contributor_name_str_mv Repositório Comum
country_str PT
creators_json_txt [{\"Person.name\":\"Sousa-Pinto, B\"},{\"Person.name\":\"Araújo, L\"},{\"Person.name\":\"Freitas, A\"},{\"Person.name\":\"Correia, O\"},{\"Person.name\":\"Delgado, L\"}]
datacite.contributors.contributor.contributorName.fl_str_mv Repositório Comum
datacite.creators.creator.creatorName.fl_str_mv Sousa-Pinto, B
Araújo, L
Freitas, A
Correia, O
Delgado, L
datacite.date.Accepted.fl_str_mv 2018-01-01T00:00:00Z
datacite.date.available.fl_str_mv 2018-02-21T19:34:14Z
datacite.date.embargoed.fl_str_mv 2018-02-21T19:34:14Z
datacite.rights.fl_str_mv http://purl.org/coar/access_right/c_abf2
datacite.subjects.subject.fl_str_mv Eritema Multiforme
Síndrome de Stevens-Johnson
Hospitalização
Erythema Multiforme
Stevens-Johnson Syndrome
Hospitalization
datacite.titles.title.fl_str_mv Stevens-Johnson syndrome/toxic epidermal necrolysis and erythema multiforme drug-related hospitalisations in a national administrative database
dc.contributor.none.fl_str_mv Repositório Comum
dc.creator.none.fl_str_mv Sousa-Pinto, B
Araújo, L
Freitas, A
Correia, O
Delgado, L
dc.date.Accepted.fl_str_mv 2018-01-01T00:00:00Z
dc.date.available.fl_str_mv 2018-02-21T19:34:14Z
dc.date.embargoed.fl_str_mv 2018-02-21T19:34:14Z
dc.format.none.fl_str_mv application/pdf
dc.identifier.none.fl_str_mv http://hdl.handle.net/10400.26/21420
dc.language.none.fl_str_mv eng
dc.rights.none.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.subject.none.fl_str_mv Eritema Multiforme
Síndrome de Stevens-Johnson
Hospitalização
Erythema Multiforme
Stevens-Johnson Syndrome
Hospitalization
dc.title.fl_str_mv Stevens-Johnson syndrome/toxic epidermal necrolysis and erythema multiforme drug-related hospitalisations in a national administrative database
dc.type.none.fl_str_mv http://purl.org/coar/resource_type/c_6501
description BACKGROUND: Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) and erythema multiforme (EM) are immunologically-mediated dermatological disorders commonly triggered by drug exposure and/or other external agents. We aimed to characterise SJS/TEN- and EM-drug-related hospitalisations in a nationwide administrative database, focusing on demographic and clinical characteristics, and in the most frequently implicated drug classes. METHODS: We analysed all drug-related hospitalisations with associated diagnosis of SJS/TEN or EM in Portuguese hospitals between 2009 and 2014. We compared gender, age, comorbidities, length of stay, and in-hospital mortality and estimated the number of episodes per million packages sold of drug classes. Predictors of in-hospital mortality were investigated in both conditions by logistic regression. RESULTS: There were 132 SJS/TEN-related and 122 EM-related hospitalisations. Incidence and in-hospital mortality of SJS/TEN episodes (24.2%) were consistent with previous studies. HIV co-infection was more common among SJS/TEN hospitalisations (9 vs. 2% with EM; P = 0.009). Liver disease, advanced age, and a TEN diagnosis, were significantly associated with higher risk of mortality in patients with SJS/TEN. The highest numbers of SJS/TEN and EM episodes per million drug packages sold were observed for antivirals (8.7 and 1.5, respectively), antineoplastic/immunosuppressive drugs (5.6 and 3.9, respectively) and hypouricaemic drugs (5.0 and 2.4, respectively). CONCLUSIONS: SJS/TEN in-hospital mortality is high, and its risk factors include advanced age, liver disease, and TEN diagnosis. The drug classes most frequently associated with these conditions include antivirals, hypouricaemic drugs and antineoplastic/immunosuppressive drugs. Administrative databases seem useful in the study of SJS/TEN drug-related hospitalisations, yielding results consistent with previous studies and on a nationwide basis.
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eu_rights_str_mv openAccess
format article
fulltext.url.fl_str_mv https://comum.rcaap.pt/bitstreams/3d80d9de-5293-43e4-9380-5e9d23238cf0/download
id cuf_58626e1eb930e7b8c846bf005d35547d
identifier.url.fl_str_mv http://hdl.handle.net/10400.26/21420
instacron_str cuf
institution CUF
instname_str CUF
language eng
network_acronym_str cuf
network_name_str Saúde - CUF
oai_identifier_str oai:comum.rcaap.pt:10400.26/21420
organization_str_mv urn:organizationAcronym:cuf
person_str_mv Sousa-Pinto, B
Araújo, L
Freitas, A
Correia, O
Delgado, L
publishDate 2018
reponame_str Saúde - CUF
repository_id_str urn:repositoryAcronym:cuf
service_str_mv urn:repositoryAcronym:cuf
spelling engpt_PTBACKGROUND: Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) and erythema multiforme (EM) are immunologically-mediated dermatological disorders commonly triggered by drug exposure and/or other external agents. We aimed to characterise SJS/TEN- and EM-drug-related hospitalisations in a nationwide administrative database, focusing on demographic and clinical characteristics, and in the most frequently implicated drug classes. METHODS: We analysed all drug-related hospitalisations with associated diagnosis of SJS/TEN or EM in Portuguese hospitals between 2009 and 2014. We compared gender, age, comorbidities, length of stay, and in-hospital mortality and estimated the number of episodes per million packages sold of drug classes. Predictors of in-hospital mortality were investigated in both conditions by logistic regression. RESULTS: There were 132 SJS/TEN-related and 122 EM-related hospitalisations. Incidence and in-hospital mortality of SJS/TEN episodes (24.2%) were consistent with previous studies. HIV co-infection was more common among SJS/TEN hospitalisations (9 vs. 2% with EM; P = 0.009). Liver disease, advanced age, and a TEN diagnosis, were significantly associated with higher risk of mortality in patients with SJS/TEN. The highest numbers of SJS/TEN and EM episodes per million drug packages sold were observed for antivirals (8.7 and 1.5, respectively), antineoplastic/immunosuppressive drugs (5.6 and 3.9, respectively) and hypouricaemic drugs (5.0 and 2.4, respectively). CONCLUSIONS: SJS/TEN in-hospital mortality is high, and its risk factors include advanced age, liver disease, and TEN diagnosis. The drug classes most frequently associated with these conditions include antivirals, hypouricaemic drugs and antineoplastic/immunosuppressive drugs. Administrative databases seem useful in the study of SJS/TEN drug-related hospitalisations, yielding results consistent with previous studies and on a nationwide basis.application/pdfpt_PTStevens-Johnson syndrome/toxic epidermal necrolysis and erythema multiforme drug-related hospitalisations in a national administrative databaseSousa-Pinto, BAraújo, LFreitas, ACorreia, ODelgado, LHostingInstitutionOrganizationalRepositório Comume-mailmailto:comum@rcaap.ptcomum@rcaap.ptDOIIsPartOf10.1186/s13601-017-0188-12018-02-21T19:34:14Z20182018-01-01T00:00:00ZHandlehttp://hdl.handle.net/10400.26/21420http://purl.org/coar/access_right/c_abf2open accessEritema MultiformeSíndrome de Stevens-JohnsonHospitalizaçãoErythema MultiformeStevens-Johnson SyndromeHospitalization821259 bytesliteraturehttp://purl.org/coar/resource_type/c_6501journal articlehttp://purl.org/coar/access_right/c_abf2application/pdffulltexthttps://comum.rcaap.pt/bitstreams/3d80d9de-5293-43e4-9380-5e9d23238cf0/download812
spellingShingle Stevens-Johnson syndrome/toxic epidermal necrolysis and erythema multiforme drug-related hospitalisations in a national administrative database
Sousa-Pinto, B
Eritema Multiforme
Síndrome de Stevens-Johnson
Hospitalização
Erythema Multiforme
Stevens-Johnson Syndrome
Hospitalization
status SINGLETON
subject.fl_str_mv Eritema Multiforme
Síndrome de Stevens-Johnson
Hospitalização
Erythema Multiforme
Stevens-Johnson Syndrome
Hospitalization
title Stevens-Johnson syndrome/toxic epidermal necrolysis and erythema multiforme drug-related hospitalisations in a national administrative database
title_full Stevens-Johnson syndrome/toxic epidermal necrolysis and erythema multiforme drug-related hospitalisations in a national administrative database
title_fullStr Stevens-Johnson syndrome/toxic epidermal necrolysis and erythema multiforme drug-related hospitalisations in a national administrative database
title_full_unstemmed Stevens-Johnson syndrome/toxic epidermal necrolysis and erythema multiforme drug-related hospitalisations in a national administrative database
title_short Stevens-Johnson syndrome/toxic epidermal necrolysis and erythema multiforme drug-related hospitalisations in a national administrative database
title_sort Stevens-Johnson syndrome/toxic epidermal necrolysis and erythema multiforme drug-related hospitalisations in a national administrative database
topic Eritema Multiforme
Síndrome de Stevens-Johnson
Hospitalização
Erythema Multiforme
Stevens-Johnson Syndrome
Hospitalization
topic_facet Eritema Multiforme
Síndrome de Stevens-Johnson
Hospitalização
Erythema Multiforme
Stevens-Johnson Syndrome
Hospitalization
url http://hdl.handle.net/10400.26/21420
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