PT -期刊文章AU -科克兰,John P . AU - Psallidas, Ioannis AU - Gerry, Stephen AU - Piccolo, Francesco AU - Koegelenberg, Coenraad F. AU - Saba, Tarek AU - Daneshvar, Cyrus AU - Fairbairn, Ian AU - Heinink, Richard AU - West, Alex AU - Stanton, Andrew E. AU - Holme, Jayne AU - Kastelik, Jack A. AU - Steer, Henry AU - Downer, Nicola J. AU - Haris, Mohammed AU - Baker, Emma H. AU - Everett, Caroline F. AU - Pepperell, Justin AU - Bewick, Thomas AU - Yarmus, Lonny AU - Maldonado, Fabien AU - Khan, Burhan AU - Hart-Thomas, Alan AU - Hands, Georgina AU - Warwick, Geoffrey AU - De Fonseka, Duneesha AU - Hassan, Maged AU - Munavvar, Mohammed AU - Guhan, Anur AU - Shahidi, Mitra AU - Pogson, Zara AU - Dowson, Lee AU - Popowicz, Natalia D. AU - Saba, Judith AU - Ward, Neil R. AU - Hallifax, Rob J. AU - Dobson, Melissa AU - Shaw, Rachel AU - Hedley, Emma L. AU - Sabia, Assunta AU - Robinson, Barbara AU - Collins, Gary S. AU - Davies, Helen E. AU - Yu, Ly-Mee AU - Miller, Robert F. AU - Maskell, Nick A. AU - Rahman, Najib M. TI - Prospective validation of the RAPID clinical risk prediction score in adult patients with pleural infection: the PILOT study AID - 10.1183/13993003.00130-2020 DP - 2020 Nov 01 TA - European Respiratory Journal PG - 2000130 VI - 56 IP - 5 4099 - //www.qdcxjkg.com/content/56/5/2000130.short 4100 - //www.qdcxjkg.com/content/56/5/2000130.full SO - Eur Respir J2020 Nov 01; 56 AB - 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 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 out of 546 patients recruited (99.3%). Overall mortality was 10% at 3 months (54 out of 542) and 19% at 12 months (102 out of 542). The RAPID risk category predicted mortality at 3 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 3 months and 12 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.This multicentre observational study shows that RAPID score can stratify adults with pleural infection into categories according to increasing risk of 3-month mortality and should inform future research directed at improving outcomes in this population https://bit.ly/37tk2LN