Toxic epidermal necrolysis data from the CELESTE multinational
registry. Part II: Specific systemic and local risk factors for
the development of infectious complications

J 2018

Toxic epidermal necrolysis data from the CELESTE multinational registry. Part II: Specific systemic and local risk factors for the development of infectious complications

LIPOVÝ, Břetislav, Jakub HOLOUBEK, Markéta HANSLIANOVÁ, Michaela CVANOVÁ, L. KLEIN et. al.

Basic information

Original name

Toxic epidermal necrolysis data from the CELESTE multinational registry. Part II: Specific systemic and local risk factors for the development of infectious complications

Authors

LIPOVÝ, Břetislav (203 Czech Republic, guarantor, belonging to the institution), Jakub HOLOUBEK (203 Czech Republic), Markéta HANSLIANOVÁ (203 Czech Republic), Michaela CVANOVÁ (203 Czech Republic, belonging to the institution), L. KLEIN (203 Czech Republic), I. GROSSOVÁ (203 Czech Republic), R. ZAJÍČEK (203 Czech Republic), P. BUKOVČAN (203 Czech Republic), J. KOLLER (203 Czech Republic), M. BARAN (203 Czech Republic), P. LENGYEL (203 Czech Republic), L. EIMER (203 Czech Republic), M. JANDOVÁ (203 Czech Republic), M. KOŠŤÁL (203 Czech Republic) and Pavel BRYCHTA (203 Czech Republic, belonging to the institution)

Edition

Burns, OXFORD, ELSEVIER SCI LTD, 2018, 0305-4179

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30212 Surgery

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 2.247

RIV identification code

RIV/00216224:14110/18:00104204

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1016/j.burns.2018.03.006

UT WoS

000444542300021

Keywords in English

toxic epidermal necrolysis; infectious complications; risk factors; CELESTE registry

Abstract

V originále

The aim of the study was to identify the most important systemic and local risk factors for the development of infectious complications in patients with toxic epidermal necrolysis (TEN). Material and methodology: This is a multicentric study that included all patients with TEN who were hospitalized between 2000-2015 in specialized centres in the Czech Republic and Slovakia. The total catchment area included a population of over 12.5 million inhabitants. The actual implementation of the project was carried out using data obtained from the CELESTE (Central European LyEll Syndrome: Therapeutic Evaluation) registry, wherein specific parameters related to epidemiological indicators and infectious complications in patients with TEN were evaluated as a retrospective analysis. Results: A total of 38 patients (97%) of the group were treated with corticosteroids. The comparison of patients with different doses of corticosteroids did not exhibit a statistically significant effect of corticosteroid administration on the development of infectious complications (p=0.421). There was no effect of the extent of the exfoliated area on the development of infectious complications in this area. The average extent of the exfoliated area was 66% TBSA (total body surface area) in patients with reported infectious complications and 71% TBSA (p=0.675) in patients without infectious complications. In the case of the development of an infectious complication in the bloodstream (BSI), the increasing effect of the SCORTEN (SCORe of Toxic Epidermal Necrosis) value was monitored during hospitalization. Within 5 days from the beginning of the hospitalization, the average SCORTEN value was 2.7 in 6 patients with BSI and 3.0 in 32 patients without BSI (p =0.588). In the period after the 15th day of hospitalization, 7 patients with BSI had an average SCORTEN value of 3.4, and 16 patients without BSI had an average SCORTEN value of 2.5 (p = 0.079). In the case of low respiratory tract infection (LRTI), the effects of the necessity for artificial pulmonary ventilation and the presence of tracheostomy were monitored. The statistically significant effect of mechanical ventilation on the development of LRTI occurred only during the period of 11-15 days from the beginning of the hospitalization (p= 0.016). The effect of the tracheostomy on the development of LRTI was proven to be more significant. Conclusion: We did not find any statistically significant correlation between the nature of immunosuppressive therapy and the risk of developing infectious complications. We failed to identify statistically significant risk factors for the development of BSI. Mechanical ventilation and tracheostomy increase the likelihood of developing LRTIs in patients with TEN. (C) 2018 Elsevier Ltd and ISBI. All rights reserved.

Citovat

LIPOVÝ, Břetislav, Jakub HOLOUBEK, Markéta HANSLIANOVÁ, Michaela CVANOVÁ, L. KLEIN, I. GROSSOVÁ, R. ZAJÍČEK, P. BUKOVČAN, J. KOLLER, M. BARAN, P. LENGYEL, L. EIMER, M. JANDOVÁ, M. KOŠŤÁL and Pavel BRYCHTA. Toxic epidermal necrolysis data from the CELESTE multinational registry. Part II: Specific systemic and local risk factors for the development of infectious complications. Burns. OXFORD: ELSEVIER SCI LTD, 2018, vol. 44, No 6, p. 1561-1572. ISSN 0305-4179. Available from: https://dx.doi.org/10.1016/j.burns.2018.03.006.

@article{1455656,
   author = {Lipový, Břetislav and Holoubek, Jakub and Hanslianová, Markéta and Cvanová, Michaela and Klein, L. and Grossová, I. and Zajíček, R. and Bukovčan, P. and Koller, J. and Baran, M. and Lengyel, P. and Eimer, L. and Jandová, M. and Košťál, M. and Brychta, Pavel},
   article_location = {OXFORD},
   article_number = {6},
   doi = {http://dx.doi.org/10.1016/j.burns.2018.03.006},
   keywords = {toxic epidermal necrolysis; infectious complications; risk factors; CELESTE registry},
   language = {eng},
   issn = {0305-4179},
   journal = {Burns},
   title = {Toxic epidermal necrolysis data from the CELESTE multinational registry. Part II: Specific systemic and local risk factors for the development of infectious complications},
   volume = {44},
   year = {2018}
}

TY  - JOUR
ID  - 1455656
AU  - Lipový, Břetislav - Holoubek, Jakub - Hanslianová, Markéta - Cvanová, Michaela - Klein, L. - Grossová, I. - Zajíček, R. - Bukovčan, P. - Koller, J. - Baran, M. - Lengyel, P. - Eimer, L. - Jandová, M. - Košťál, M. - Brychta, Pavel
PY  - 2018
TI  - Toxic epidermal necrolysis data from the CELESTE multinational registry. Part II: Specific systemic and local risk factors for the development of infectious complications
JF  - Burns
VL  - 44
IS  - 6
SP  - 1561-1572
EP  - 1561-1572
PB  - ELSEVIER SCI LTD
SN  - 03054179
KW  - toxic epidermal necrolysis
KW  - infectious complications
KW  - risk factors
KW  - CELESTE registry
N2  - The aim of the study was to identify the most important systemic and local risk factors for the development of infectious complications in patients with toxic epidermal necrolysis (TEN). Material and methodology: This is a multicentric study that included all patients with TEN who were hospitalized between 2000-2015 in specialized centres in the Czech Republic and Slovakia. The total catchment area included a population of over 12.5 million inhabitants. The actual implementation of the project was carried out using data obtained from the CELESTE (Central European LyEll Syndrome: Therapeutic Evaluation) registry, wherein specific parameters related to epidemiological indicators and infectious complications in patients with TEN were evaluated as a retrospective analysis. Results: A total of 38 patients (97%) of the group were treated with corticosteroids. The comparison of patients with different doses of corticosteroids did not exhibit a statistically significant effect of corticosteroid administration on the development of infectious complications (p=0.421). There was no effect of the extent of the exfoliated area on the development of infectious complications in this area. The average extent of the exfoliated area was 66% TBSA (total body surface area) in patients with reported infectious complications and 71% TBSA (p=0.675) in patients without infectious complications. In the case of the development of an infectious complication in the bloodstream (BSI), the increasing effect of the SCORTEN (SCORe of Toxic Epidermal Necrosis) value was monitored during hospitalization. Within 5 days from the beginning of the hospitalization, the average SCORTEN value was 2.7 in 6 patients with BSI and 3.0 in 32 patients without BSI (p =0.588). In the period after the 15th day of hospitalization, 7 patients with BSI had an average SCORTEN value of 3.4, and 16 patients without BSI had an average SCORTEN value of 2.5 (p = 0.079). In the case of low respiratory tract infection (LRTI), the effects of the necessity for artificial pulmonary ventilation and the presence of tracheostomy were monitored. The statistically significant effect of mechanical ventilation on the development of LRTI occurred only during the period of 11-15 days from the beginning of the hospitalization (p= 0.016). The effect of the tracheostomy on the development of LRTI was proven to be more significant. Conclusion: We did not find any statistically significant correlation between the nature of immunosuppressive therapy and the risk of developing infectious complications. We failed to identify statistically significant risk factors for the development of BSI. Mechanical ventilation and tracheostomy increase the likelihood of developing LRTIs in patients with TEN. (C) 2018 Elsevier Ltd and ISBI. All rights reserved.
ER  -

LIPOVÝ, Břetislav, Jakub HOLOUBEK, Markéta HANSLIANOVÁ, Michaela CVANOVÁ, L. KLEIN, I. GROSSOVÁ, R. ZAJÍČEK, P. BUKOVČAN, J. KOLLER, M. BARAN, P. LENGYEL, L. EIMER, M. JANDOVÁ, M. KOŠŤÁL and Pavel BRYCHTA. Toxic epidermal necrolysis data from the CELESTE multinational registry. Part II: Specific systemic and local risk factors for the development of infectious complications. \textit{Burns}. OXFORD: ELSEVIER SCI LTD, 2018, vol.~44, No~6, p.~1561-1572. ISSN~0305-4179. Available from: https://dx.doi.org/10.1016/j.burns.2018.03.006.

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