Corcoran, JP;
Psallidas, I;
Gerry, S;
Piccolo, F;
Koegelenberg, CF;
Saba, T;
Daneshvar, C;
Fairbairn, I;
Heinink, R;
West, A;
et al.
Corcoran, JP; Psallidas, I; Gerry, S; Piccolo, F; Koegelenberg, CF; Saba, T; Daneshvar, C; Fairbairn, I; Heinink, R; West, A; Stanton, AE; Holme, J; Kastelik, JA; Steer, H; Downer, NJ; Haris, M; Baker, EH; Everett, CF; Pepperell, J; Bewick, T; Yarmus, L; Maldonado, F; Khan, B; Hart-Thomas, A; Hands, G; Warwick, G; De Fonseka, D; Hassan, M; Munavvar, M; Guhan, A; Shahidi, M; Pogson, Z; Dowson, L; Popowicz, ND; Saba, J; Ward, NR; Hallifax, RJ; Dobson, M; Shaw, R; Hedley, EL; Sabia, A; Robinson, B; Collins, GS; Davies, HE; Yu, L-M; Miller, RF; Maskell, NA; Rahman, NM
(2020)
Prospective validation of the RAPID clinical risk prediction score in adult patients with pleural infection: the PILOT study.
Eur Respir J, 56 (5).
p. 2000130.
ISSN 1399-3003
https://doi.org/10.1183/13993003.00130-2020
SGUL Authors: Baker, Emma Harriet
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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 (RAPID - Renal (urea), Age, fluid Purulence, Infection source, Dietary (albumin)) in adults with pleural infection. METHODS: Prospective observational cohort study recruiting patients undergoing treatment for pleural infection. RAPID score and risk category were calculated at baseline presentation. The primary outcome was mortality at 3 months; secondary outcomes were mortality at 12 months, length of hospital stay, need for thoracic surgery, failure of medical treatment, and lung function at 3 months. RESULTS: Mortality data were available in 542 of 546 (99.3%) patients recruited. Overall mortality was 10% (54/542) at 3 months and 19% (102/542) at 12 months. The RAPID risk category predicted mortality at 3 months; low-risk (RAPID score 0-2) mortality 5/222 (2.3%, 95%CI 0.9 to 5.7), medium-risk (RAPID score 3-4) mortality 21/228 (9.2%, 95%CI 6.0 to 13.7), and high-risk (RAPID score 5-7) mortality 27/92 (29.3%, 95%CI 21.0 to 39.2). C-statistics for the score at 3 and 12 months were 0.78 (95%CI 0.71 to 0.83) and 0.77 (95%CI 0.72 to 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.
Item Type: |
Article
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Additional Information: |
This is an author-submitted, peer-reviewed version of a manuscript that has been accepted for publication in the European Respiratory Journal, prior to copy-editing, formatting and typesetting. This version of the manuscript may not be duplicated or reproduced without prior permission from the copyright owner, the European Respiratory Society. The publisher is not responsible or liable for any errors or omissions in this version of the manuscript or in any version derived from it by any other parties. The final, copy-edited, published article, which is the version of record, is available without a subscription 18 months after the date of issue publication. |
Keywords: |
11 Medical and Health Sciences, Respiratory System |
SGUL Research Institute / Research Centre: |
Academic Structure > Infection and Immunity Research Institute (INII) |
Journal or Publication Title: |
Eur Respir J |
ISSN: |
1399-3003 |
Language: |
eng |
Dates: |
Date | Event |
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26 November 2020 | Published | 16 July 2020 | Published Online | 6 June 2020 | Accepted |
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Publisher License: |
Publisher's own licence |
Projects: |
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PubMed ID: |
32675200 |
![](http://static.pubmed.gov/portal/portal3rc.fcgi/2745237/img/27842) |
Go to PubMed abstract |
URI: |
https://openaccess.sgul.ac.uk/id/eprint/112175 |
Publisher's version: |
https://doi.org/10.1183/13993003.00130-2020 |
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