Severity of Illness Score for Toxic Epidermal Necrolysis (SCORTEN score)

The SCORTEN score, also known as the Severity of Illness Score for Toxic Epidermal Necrolysis, is a clinical tool used to predict mortality in patients diagnosed with Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN). These are severe skin reactions, often to medication, that can be life-threatening. The SCORTEN score is calculated based on seven clinical and laboratory parameters, each contributing one point to the total score. These parameters include age, malignancy, heart rate, initial body surface area of epidermal detachment, serum urea, serum glucose, and bicarbonate levels. The higher the SCORTEN score, the higher the predicted mortality rate. This score is particularly useful in the early stages of disease to guide treatment decisions and inform discussions about prognosis with patients and their families. There are no specific exclusion criteria for the use of the SCORTEN score, but it should be noted that it is most accurate when applied within the first 24-48 hours of hospital admission for SJS/TEN. It may not be as accurate in predicting outcomes for patients with less severe forms of the disease or for those with other severe concurrent illnesses.

Reference

S Bastuji-Garin, N Fouchard, M Bertocchi et al. SCORTEN: a severity-of-illness score for toxic epidermal necrolysis. J Invest Dermatol. 2000 Aug;115(2):149-53.