Hospital readmissions among patients with Stevens-Johnsons syndrome/toxic epidermal necrolysis (SJS/TEN) are common, according to the findings of a recent study. The study, published in the Journal of American Academy of Dermatology, showed several comorbidities and patient characteristics were predictive of 30-day hospital readmission among this patient population, which could help physicians identify at-risk patients.
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In the cross-sectional study, the researchers investigated variables predictive of 30-day remission among 8837 patients with indexed admissions of SJS/TEN enrolled in the 2010 to 2014 Nationwide Readmissions Database. They used bivariate and multivariable logistic regression to evaluate the associations between readmissions and patient demographics, comorbidities, and hospital characteristics. In addition, the researchers calculated aggregate and pre-readmissions costs.
Overall, 910 (10.3%) patients were readmitted with diagnoses including systemic infection (22%), SJS/TEN (20.6%), and cutaneous infection (9.1%), the researchers said.
Characteristics associated with readmission included age 45 to 64 years (odd ratio [OR] 1.88; 95% CI, 1.43-2.49), Medicaid insurance (OR 1.83; 95% CI 1.48-2.27), and non-metropolitan hospital admission (OR 1.67l; 95% CI, 1.31-2.13). HIV/AIDS (OR 2.48; 95% CI 1.63-3.75), collagen vascular disease (OR 2.38; 95% CI, 1.88-3.0), and metastatic cancer (OR 2.16; 95% CI 1.35-3.46) were associated with readmissions.
In addition, the researchers found the median pre-readmission cost was $10,019 (interquartile range $4,788 to $16,485).
“Thirty-day readmissions after SJS/TEN hospitalizations are common,” the researchers concluded. “Dedicated efforts to identify at-risk patients may improve peri-discharge continuity.”
Guzman AK, Zhang M, Kwatra SG, Kaffenberger BH. Predictors of 30-day readmission in Stevens-Johnson syndrome and toxic epidermal necrolysis: A retrospective, cross-sectional database study [published online September 19, 2019]. J Am Acad Dermatol. doi:10.1016/j.jaad.2019.09.017