Suthawal Deepak Kumar, Rajawat Govind Singh, Koolwal Suresh, Chaudhary Komal
Department of Respiratory Medicine, RVRS Medical College Bhilwara, Rajasthan, India.
Department of Respiratory Medicine, SMS, Medical College, Jaipur, Rajasthan, India.
Lung India. 2025 Mar 1;42(2):97-102. doi: 10.4103/lungindia.lungindia_222_24. Epub 2025 Feb 27.
In this study we evaluated the utility of RAPID score in Parapneumonic effusion and empyema. Both of which are most common causes of exudative pleural effusion and this score was developed by Rahman et al by using multicentre intrapleural trial 1[MIST1 and MIST2]. Most of the patients with parapneumonic effusion usually recovers but mortality rate still around 10% along with long hospital stay, surgical interventions requirement, morbidity (3-month follow up) despite of advances in treatment specially in empyema cases. For this reason, this study was done as there is no such study have done by anyone in our knowledge specially in India. After calculating RAPID score in pleural infection then patients were stratified in the different risk categories and association was compared with these risk categories with different variables.
This is a prospective study at tertiary in which clinical utility of RAPID score in pleural infection in INDIAN population where tuberculosis infection is predominant. Baseline RAPID score was calculated on admission and stratified into risk category according to RAPID score. Primary outcome both mortality and morbidity, secondary outcome need of surgical interventions, length of hospital at 3-months in different risk category.
Overall, 120 patients were included in this study. Mortality was 7 (5.83%) in our study. Total 17 (14.17%) patients needed surgery and length of hospital study was compared in all three categories of RAPID score. Total 26 (21.67%) patients had <7 days and 94 (78.33%) >7 days hospital stays. Most common organism isolate was mycobacterium tuberculosis. RAPID score was compared in Tubercular And non-tubercular organisms.
Prognostic utility of RAPID score is well established especially in non-tubercular organisms. Here, in our study management utility of RAPID score also found useful. It performs good some aspects in tubercular aetiology.
在本研究中，我们评估了RAPID评分在类肺炎性胸腔积液和脓胸中的应用价值。这两种情况都是渗出性胸腔积液最常见的病因，该评分由拉赫曼等人通过多中心胸腔内试验1（MIST1和MIST2）得出。尽管在治疗方面取得了进展，特别是在脓胸病例中，但大多数类肺炎性胸腔积液患者通常能够康复，不过死亡率仍约为10%，且住院时间长、需要手术干预、存在并发症（3个月随访）。因此，据我们所知，特别是在印度，此前没有人进行过此类研究，所以开展了本研究。在计算胸膜感染的RAPID评分后，将患者分层到不同的风险类别，并将这些风险类别与不同变量进行关联比较。
这是一项在三级医疗机构开展的前瞻性研究，评估RAPID评分在以结核感染为主的印度人群胸膜感染中的临床应用价值。入院时计算基线RAPID评分，并根据RAPID评分将患者分层到风险类别。主要结局为死亡率和并发症，次要结局为不同风险类别中手术干预的必要性、3个月时的住院时间。
本研究共纳入120例患者。我们研究中的死亡率为7例（5.83%）。共有17例（14.17%）患者需要手术，并对RAPID评分的所有三个类别中的住院时间进行了比较。共有26例（21.67%）患者住院时间<7天，94例（78.33%）患者住院时间>7天。最常见的分离病原体是结核分枝杆菌。对结核和非结核病原体的RAPID评分进行了比较。
RAPID评分的预后价值已得到充分证实，尤其是在非结核病原体方面。在我们的研究中，RAPID评分在管理方面也被发现是有用的。它在结核病因的某些方面表现良好。
