Journal of the American Academy of Dermatology · 2025
Development and validation of prognostic models using novel inflammatory markers for drug reactions with eosinophilia and systemic symptoms: An international multicenter cohort study.
СтатьяМногоцентровое исследованиеВалидационное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Hsieh Tyng-Shiuan, Lee Haur Yueh, Abe Riichiro, Takei Shingo, Hayashi Ryota, Hama Natsumi, Cho Yung-Tsu, Huang Po-Wei, Chu Chia-Yu
Аннотация
BACKGROUND: Drug reaction with eosinophilia and systemic symptoms (DRESS) is a life-threatening disease that has received little attention focusing on its prognostic markers.
OBJECTIVE: We evaluated the association between novel inflammatory markers and in-hospital mortality. We also proposed and validated a risk stratification model to aid early intervention.
METHODS: This international multicenter, retrospective cohort study included 169 patients diagnosed with DRESS from Taiwan, Singapore, and Japan, collecting demographics and laboratory markers within 3 days of diagnosing DRESS. Inflammatory markers were calculated, and statistical analyses, including logistic regression and receiver operating characteristic curve analysis. Predictive models were developed with internal validation using leave-one-out cross-validation.
RESULTS: Lower hemoglobin-to-red blood cell distribution width ratio, higher platelet-to-lymphocyte ratio, and lower monocyte count are identified as significant predictors of mortality in a multivariate analysis. A predictive model for DRESS-related mortality, incorporating the significant inflammatory markers and underlying disease (malignancy, autoimmune disease, and cardiovascular disease), demonstrated good discrimination ability and acceptable accuracy.
LIMITATION: The retrospective design, along with factors like interhospital transfers, and underlying malignancies are limitations.
CONCLUSION: The presence of these novel inflammatory markers and the development of risk stratification model may be of value to stratification of the severity of DRESS.
OBJECTIVE: We evaluated the association between novel inflammatory markers and in-hospital mortality. We also proposed and validated a risk stratification model to aid early intervention.
METHODS: This international multicenter, retrospective cohort study included 169 patients diagnosed with DRESS from Taiwan, Singapore, and Japan, collecting demographics and laboratory markers within 3 days of diagnosing DRESS. Inflammatory markers were calculated, and statistical analyses, including logistic regression and receiver operating characteristic curve analysis. Predictive models were developed with internal validation using leave-one-out cross-validation.
RESULTS: Lower hemoglobin-to-red blood cell distribution width ratio, higher platelet-to-lymphocyte ratio, and lower monocyte count are identified as significant predictors of mortality in a multivariate analysis. A predictive model for DRESS-related mortality, incorporating the significant inflammatory markers and underlying disease (malignancy, autoimmune disease, and cardiovascular disease), demonstrated good discrimination ability and acceptable accuracy.
LIMITATION: The retrospective design, along with factors like interhospital transfers, and underlying malignancies are limitations.
CONCLUSION: The presence of these novel inflammatory markers and the development of risk stratification model may be of value to stratification of the severity of DRESS.