SCORTEN Scale
Evaluates severity of certain skin conditions, from toxic epidermal necrolysis to burns or Stevens-Johnson Syndrome.
Refer to the text below the calculator for more information on the usage of the score and the original study.
The SCORe of Toxic Epidermal Necrosis (SCORTEN scale) is a severity-of-illness type of scale originally developed for evaluation of toxic epidermal necrolysis, but now also used for the cutaneous assessment in Stevens-Johnson Syndrome patients, burn victims, patients with cutaneous drug reactions or exfoliative wounds.
The SCORTEN scale consists in 7 independent risk factors for high mortality, the presence of which is interpreted as follows:
| No of risk factors | Mortality Rate |
| 0 or 1 | 3.2% |
| 2 | 12.1% |
| 3 | 35.3% |
| 4 | 58.3% |
| 5 or more | >90% |
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SCORTEN Scale explained
The SCORe of Toxic Epidermal Necrosis (SCORTEN scale) is a severity-of-illness type of scale originally developed for evaluation of toxic epidermal necrolysis, but now also used for the cutaneous assessment in Stevens-Johnson Syndrome patients, burn victims, patients with cutaneous drug reactions or exfoliative wounds.
The SCORTEN scale consists in 7 independent risk factors for high mortality, the presence of which is scored with 1 point for each present and interpreted as follows:
- Age ≥40 years
- Heart rate ≥120 beats per min
- Cancer/hematologic malignancy
- BSA detached ≥10% (at day 1)
- Serum BUN >10 mmol/L
- Serum bicarbonate <20 mmol/L
- Serum glucose >14 mmol/L
SCORTEN Score Interpretation
| No of risk factors | Mortality Rate |
| 0 or 1 | 3.2% |
| 2 | 12.1% |
| 3 | 35.3% |
| 4 | 58.3% |
| 5 or more | >90% |
Subsequent validation studies have found that the performance and accuracy of SCORTEN for predicting in-hospital mortality was excellent, however, as widely recognized, no mortality probability models cannot 100% predict outcomes in individual patients so clinical gestalt and caution must be exercised.
About the original study
The original study by Bastuji-Garin et al. to develop and validate a specific severity-of-illness score for cases of toxic epidermal necrolysis. During the same study, the SCORTEN scale was compared with the Simplified Acute Physiology Score and a burn scoring system.
Two samples of 165, respectively 75 patients were used, the second one for validation purposes. Model development used logistic regression equations that were translated into probability of hospital mortality.
Seven risk factors were identified. For each toxic epidermal necrolysis-specific severity-of-illness score point the odds ratio was 3.45 (confidence interval 2.26-5.25).
Calibration demonstrated excellent agreement between expected (19. 6%) and actual (20%) mortality. Discrimination was also found to be excellent with a receiver operating characteristic ROC area of 82%.
References
Original reference
Bastuji-Garin S, Fouchard N, Bertocchi M, Roujeau JC, Revuz J, Wolkenstein P. SCORTEN: a severity-of-illness score for toxic epidermal necrolysis. J Invest Dermatol. 2000 Aug;115(2):149-53.
Validation
Zhu, Q.Y., Ma, L., Luo, X.Q., and Huang, H.Y. Toxic epidermal necrolysis: performance of SCORTEN and the score-based comparison of the efficacy of corticosteroid therapy and intravenous immunoglobulin combined therapy in China. J Burn Care Res. 2012; 33: e295–e308.
Other references
Seecof, Olivia M.Liantonio, John et al. Prognostication Using SCORTEN Severity of Illness Score in Patients With Stevens Johnson Syndrome and Toxic Epidermal Necrolysis. Journal of Pain and Symptom Management, Volume 57, Issue 1, e8 - e9.
Specialty: Dermatology
Objective: Evaluation
Type: Scale
No. Of Items: 7
Year Of Study: 2000
Article By: Denise Nedea
Published On: May 18, 2020 · 12:00 AM
Last Checked: May 18, 2020
Next Review: May 18, 2025