RAPID Score for Pleural Infection

Factors associated with high risk scores include gram-negative rod infections, heart disease, diabetes, cancer, lung disease, and increased length of stay. Consider erring on the side of caution in patients with these.

• It is not yet known how best to manage patients based on RAPID Score; however:
  • Patients who are low risk may be better candidates for invasive surgical therapy, including thoracotomy or video-assisted thoracoscopic surgery (VATS).
  • Some higher risk patients may benefit from earlier aggressive intervention to minimize the chances of poor outcomes.
  • Higher risk patients who are sicker at presentation may be better suited for less invasive therapies like tube thoracostomy and fibrinolytics.
• Knowledge of the RAPID Score may help physicians advise patients and family members regarding the likely duration of stay in hospital and, if appropriate, their risk of mortality.

• The RAPID Score has yet to be prospectively validated in a large trial setting and so its role in routine clinical care is not fully formed.
• Clinical decisions regarding the treatment of pleural infection must always be taken with local variability in mind, especially relating to the availability of thoracic surgery and knowledge of likely causative organisms.
• The RAPID Score does not dictate treatment, but rather gives better information about the patient at presentation.