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Abstract Objective: This study aims to correlate the RAPID score with the 3-month survival and surgical results of patients undergoing lung decortication with stage III pleural empyema. Methods: This was a retrospective study with the population of patients with pleural empyema who underwent pulmonary decortication between January 2019 and June 2022. Data were collected from the institution's database, and patients were classified as low, medium, and high risk according to the RAPID score. The primary outcome was 3-month mortality. Secondary outcomes were the length of hospital stay, readmission rate, and the need for pleural re-intervention. Results: Of the 34 patients with pleural empyema, according to the RAPID score, patients were stratified into low risk (23.5 %), medium risk (47.1 %), and high risk (29.4 %). The high-risk group had a 3-month mortality of 40 %, while the moderate-risk group hada 6.25 % and the low-risk group had no deaths within 90days, confirmingagood correlation with the RAPID score (p < 0.05). Sensitivity and specificity for the primary outcome in the high-risk score were 80.0 % and 79.3%, respectively. The secondary outcomes did not reach statistical significance. Conclusions: In this retrospective series, the RAPID score had a good correlation with 3-month mortality in patients undergoing lung decortication. The morbidity indicators did not reach statistical significance. The present data justifies further studies to explore the capacity of the RAPID score to be used as a selection tool for treatment modality in patients with stage III pleural empyema.
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Objective:To explore the clinical characteristics, chest imaging manifestations, RAPID score and therapeutic situation in patients with parapneumonic pleural effusion (PPE) caused by streptococcus anginosus group (SAG), in order to provide help for the early diagnosis and treatment in clinical practices. Methods:The clinical data of 39 patients with PPE caused by SAG from January 2015 to May 2020 in Affiliated Hospital of Jining Medical University and Jining First People′s Hospital were retrospectively analyzed. The patients were classified by RAPID score.Results:Among 39 cases, males was in 31 cases (79.5%), females in 8 cases (20.5%), and aged 46 to 89 (65.31±10.53) years old. Fever was in 27 cases (69.2%), chest pain in 19 cases (48.7%), and dyspnea in 18 cases (46.2%). The chest CT findings showed consolidation shadows was in 30 cases (76.9%), encapsulated pleural effusion in 21 cases (53.8%), ground glass shadow in 18 cases (46.2%), nodules in 12 cases (30.8%), atelectasis in 8 cases (20.5%), and pneumothorax in 5 cases (12.8%). The complexity PPE was in 23 cases (59.0%), and empyema in 16 cases (41.0%). The microbiological culture results showed that streptococcus constellatus was detected in 25 cases (64.1%), streptococcus anginosus in 13 cases (33.3%), and streptococcus intermadius in 1 case (2.6%). After comprehensive treatment, 36 cases (92.3%) were improved, 3 cases (7.7%) died. According to the RAPID score, low-risk was in 13 cases (33.3%), intermediate-risk in 16 cases (41.0%), and high-risk in 10 cases (25.7%). The RAPID score in patients with low-risk, intermediate-risk and high-risk was (1.85 ± 0.38), (3.43 ± 0.51) and (5.30 ± 0.67) scores, and there was statistical difference ( F = 124.88, P<0.05). the length of stay in patients with low-risk, intermediate-risk and high-risk of RAPID score was (16.84 ± 5.57), (16.56 ± 7.05) and (28.20 ± 17.97) d, and there was statistical difference ( F = 4.41, P<0.05); the length of stay in patients with high-risk was significantly longer than that in patients with low-risk and intermediate-risk, and there was statistical difference ( P<0.05), there was no statistical difference between intermediate-risk patients and low-risk patients ( P>0.05). Conclusions:SAG, as important pathogens for the PPE, tends to induce CPPE and even pyopneumothorax. Clinical manifestations and imaging are not specific, which should be payed attention in clinical work. The patients with high-risk of RAPID score have more serious condition and worse prognosis.