Risk Factors for Mortality in Senile Patients with Toxic Epidermal Necrolysis in Taiwan

Background: Toxic epidermal necrolysis (TEN) is a rare and potentially fatal disorder that manifests as large areas of bullous skin lesions. Early diagnosis and appropriate management are essential for survival. It is associated with a high mortality rate, especially among elderly patients. However, there have been no specific reports targeting elderly TEN patients. The aim of this study was to determine risk factors for mortality in elderly patients with TEN. Methods: A retrospective review of 19 patients with pathologically confirmed TEN in the burn unit (BU) of a tertiary medical center from January 2004 to December 2015 was conducted. Comparison between survivors and non-survivors was based on clinical findings, laboratory data, complications, and management strategies. Results: The mortality rate among the 19 patients was 52.6%. The average duration of BU stay was 11.6 days. Significant differences between the two groups were observed in albumin level and delay of transfer to a BU. Conclusion: Early transfer to a BU for supportive treatment is essential for elderly TEN patients. Patients with hypoalbuminemia have a high risk for mortality, and infection prevention is essential for survival.