Prospective validation of the RAPID clinical risk prediction score in adult patients with pleural infection: the PILOT study.
Eur Respir J
; 56(5)2020 11.
Article
in En
| MEDLINE
| ID: mdl-32675200
ABSTRACT
BACKGROUND:
Over 30% of adult patients with pleural infection either die and/or require surgery. There is no robust means of predicting at baseline presentation which patients will suffer a poor clinical outcome. A validated risk prediction score would allow early identification of high-risk patients, potentially directing more aggressive treatment thereafter.OBJECTIVES:
To prospectively assess a previously described risk score (the RAPID (Renal (urea), Age, fluid Purulence, Infection source, Dietary (albumin)) score) in adults with pleural infection.METHODS:
Prospective observational cohort study that recruited patients undergoing treatment for pleural infection. RAPID score and risk category were calculated at baseline presentation. The primary outcome was mortality at 3â months; secondary outcomes were mortality at 12â months, length of hospital stay, need for thoracic surgery, failure of medical treatment and lung function at 3â months.RESULTS:
Mortality data were available in 542 out of 546 patients recruited (99.3%). Overall mortality was 10% at 3â months (54 out of 542) and 19% at 12â months (102 out of 542). The RAPID risk category predicted mortality at 3â months. Low-risk mortality (RAPID score 0-2) five out of 222 (2.3%, 95% CI 0.9 to 5.7%); medium-risk mortality (RAPID score 3-4) 21 out of 228 (9.2%, 95% CI 6.0 to 13.7%); and high-risk mortality (RAPID score 5-7) 27 out of 92 (29.3%, 95% CI 21.0 to 39.2%). C-statistics for the scores at 3â months and 12â months were 0.78 (95% CI 0.71-0.83) and 0.77 (95% CI 0.72-0.82), respectively.CONCLUSIONS:
The RAPID score stratifies adults with pleural infection according to increasing risk of mortality and should inform future research directed at improving outcomes in this patient population.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pleural Diseases
Type of study:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Humans
Language:
En
Journal:
Eur Respir J
Year:
2020
Type:
Article
Affiliation country:
United kingdom