{
  "abstract": "Background Pleural infection poses significant clinical challenges due to its high morbidity and mortality. The RAPID score, a validated risk stratification model incorporating Renal function, Age, Purulence of pleural fluid, Infection source, and Dietary factor, effectively predict patients’ outcomes. However, the clinical utility of the RAPID score across different healthcare systems remain undefined.Objective To systematically review and meta-analyse current literature on the prognostic value of the RAPID score in patients with pleural infection, focusing on its ability to predict 3-month mortality and its association with secondary clinical outcomes.Methods A comprehensive literature search was conducted across PubMed, Ovid Embase, and Central Register of Controlled Trials, following PRISMA guidelines. Studies evaluating the RAPID score in adults with pleural infection and reporting on mortality or related outcomes were included. The primary outcome was 3-month mortality rate. Secondary outcomes were length of hospital stay, use of intrapleural enzyme therapy (IET), and need for surgical intervention. Two independent reviewers extracted the data and performed quality assessment. Random-effects meta-analyses were conducted to pool effect estimates.Results A total of nine studies met the inclusion criteria, including 3,179 patients. The pooled analysis demonstrated that patients with high RAPID scores had significantly higher overall 3-month mortality (31.9%; 95% CI: 25.6%–38.9%) compared to low RAPID and medium score groups; 3.4% (1.9 – 5.9%), 11.6% (8.4 – 16.0%), longer hospital stays 18.8 days vs 15.8 days in low group, increasing likelihood of needing of IET 75.0 (71.3 – 78.4) vs (10.4%;2.1 – 38.7) and (72.0%;81.5 – 98.7%) in low and medium score groups respectively and higher surgical intervention 19.5% (9.9 – 35.0%) vs 10.3% (5.2 – 19.6%) in low score.Conclusion This study supports the evidence that patients with pleural infection with a higher RAPID score have more complicated clinical course and higher mortality rate. Adoption of RAPID score-based clinical decision-making pathway at baseline may facilitate early risk stratification and personalised treatment approaches.",
  "authors": [
    {
      "affiliations": [
        "Oxford Respiratory Trials Unit, Oxford, UK"
      ],
      "name": "A Elsheikh"
    },
    {
      "affiliations": [
        "Oxford University NHS Foundation Trust, Oxford, UK"
      ],
      "name": "C Mounsey"
    },
    {
      "affiliations": [
        "Oxford Respiratory Trials Unit, Oxford, UK"
      ],
      "name": "B Iqbal"
    },
    {
      "affiliations": [
        "Oxford Respiratory Trials Unit, Oxford, UK"
      ],
      "name": "D Addala"
    },
    {
      "affiliations": [
        "Oxford University NHS Foundation Trust, Oxford, UK"
      ],
      "name": "WM Chew"
    },
    {
      "affiliations": [
        "Oxford University NHS Foundation Trust, Oxford, UK"
      ],
      "name": "K Kogh"
    },
    {
      "affiliations": [
        "Oxford University NHS Foundation Trust, Oxford, UK"
      ],
      "name": "E Bedawi"
    },
    {
      "affiliations": [
        "Oxford University NHS Foundation Trust, Oxford, UK"
      ],
      "name": "O Walsh"
    },
    {
      "affiliations": [
        "Oxford University NHS Foundation Trust, Oxford, UK"
      ],
      "name": "M Bhatnagar"
    },
    {
      "affiliations": [
        "Oxford University NHS Foundation Trust, Oxford, UK"
      ],
      "name": "E Harriss"
    },
    {
      "affiliations": [
        "Univeristy of East Anglia, Norwich, UK"
      ],
      "name": "S Llaneza Lago"
    },
    {
      "affiliations": [
        "Univeristy of East Anglia, Norwich, UK"
      ],
      "name": "E Mishra"
    },
    {
      "affiliations": [
        "Oxford University NHS Foundation Trust, Oxford, UK"
      ],
      "name": "R Hallifax"
    },
    {
      "affiliations": [
        "Oxford University NHS Foundation Trust, Oxford, UK"
      ],
      "name": "N Rahman"
    }
  ],
  "title": "P269 Utility of the RAPID score as a risk prediction tool in the management of patients with pleural infection: a systematic review and meta-analysis",
  "uid": "9ecf7377-7275-5974-be32-803d5a2d791a"
}