Higher Income Quartile is Associated With Lower Inpatient Mortality and Complications in Stevens-Johnson Syndrome / Toxic Epidermal Necrolysis

Document Type

Conference Proceeding

Publication Date

8-2026

Publication Title

Journal of Investigative Dermatology

Abstract

While clinical severity scores such as SCORTEN incorporate individual-level predictors of mortality, the impact of socioeconomic factors on short-term outcomes in Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) remains poorly characterized. This study examined the association between neighborhood income quartiles and inpatient outcomes among patients with SJS/TEN who were hospitalized in the United States. We conducted a retrospective cohort study using the National Inpatient Sample from 2017 to 2022. Adult hospitalizations for SJS, TEN, and SJS/TEN overlap were identified using International Classification of Diseases, Tenth Revision codes. Median household income by patient ZIP code was categorized into quartiles. Primary outcomes included in-hospital mortality, sepsis, septic shock, acute kidney injury, and need for endotracheal intubation. Survey-weighted multivariable logistic regression models adjusted for patient demographics, Charlson comorbidity index, primary expected payer, hospital characteristics, and admission year. Compared with patients in the lowest income quartile, those in the highest income quartile had significantly lower odds of in-hospital mortality (adjusted odds ratio [aOR] 0.703, 95% confidence interval [CI] 0.508–0.974). The highest income quartile was also associated with lower odds of sepsis (aOR 0.760, 95% CI 0.630–0.918), septic shock (aOR 0.671, 95% CI 0.503–0.896), acute kidney injury (aOR 0.731, 95% CI 0.608–0.880), and need for endotracheal intubation (aOR 0.646, 95% CI 0.490–0.850). No statistically significant associations were observed for the second- or third-income quartiles or for other complications. Higher neighborhood income was independently associated with lower mortality and reduced risk of major complications among hospitalized patients with SJS/TEN, highlighting income-related disparities in acute care for this high-risk population.

Volume

146

Issue

8 Suppl

First Page

S128

Comments

Society for Investigative Dermatology (SID) Annual Meeting, May 13-16, 2026, Chicago, IL

Last Page

S128

DOI

10.1016/j.jid.2026.06.766

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