Pleural empyema in hospitalization and mortality risk: application of RAPID score

In recent years, the incidence of pleural infections has increased, which is a problem in terms of mortality, need for surgical drainage and long hospital stay. In 2014 RAPID score was published to identify cases with highest probability of poor evolution, with the intention of optimizing treatment(medical/surgical)before the deterioration of the patient. Through five initial parameters(function kidney, age, purulence of pleural fluid, site of acquisition and status nutritional)the risk of poor evolution was stratified into low(0-2 points), medium(3-4 points) and high(5-7 points). Our objective is to verify the usefulness of this scale in a Spanish population sample to verify the degree of correlation between the score obtained and the mortality and hospital stay(data of poor evolution). It is a retrospective study of 140 cases of empyema assisted under conditions of routine clinical practice from January 2015-September 2019. Data were collected on the RAPID score variables as well as mortality and hospital stay. Statistical analysis was performed with SPSS considering statistically significant those results with a p <0.05. In terms of mortality, 2 deaths(low risk group, 2.8%), 7(risk medium, 18.9%) and 5(high risk, 29.4%), statistically significant(X2: 9.0; p 0.01). In terms of hospitalization days, median 13.5 days(low risk), 18(medium risk), and 25.5(high risk), statistically significant(ANOVA: 17157; p 0.01) (Figure 1). In the survival analysis, median survival of 14 days(low risk), 21(medium risk) group and 26(high risk)(Log Rank 30,0; p <0.01)(Figure 2). In conclusion, RAPID score is a good tool to establish the probability of poor evolution in empyema due to increased mortality and hospital stay.