RISK STRATIFICATION IN PATIENTS WITH COMPLICATED PARAPNEUMONIC EFFUSIONS AND EMPYEMA USING THE RAPID SCORE

Abstract

Background: Complex parapneumonic effusions and empyema are severe pulmonary infections that need prompt attention. Prognostic instruments are important for risk stratification and clinical management for the prevention of morbidity and mortality. For these situations, the RAPID score is a validated risk stratification tool.

Objective: To evaluate the prognostic value of the RAPID score in patients with complicated Parapneumonic effusion (PPE) and empyema, and to assess its association with clinical outcome, comorbidities, and length of hospital stay.

Methods: This was a cross-sectional study of 78 patients with complicated Parapneumonic effusion and empyema admitted to a tertiary care hospital until October 2024. Patients were divided into risk category (Low [RAPID 0–2], Moderate [RAPID 3–4] and High [RAPID 5–7]). Information obtained was demographic, comorbidities like diabetes mellitus, hypertension, duration of hospital stay and clinical outcomes like discharge, referral and mortality. For comparison of risk groups an ANOVA and Chi-square-test was used for statistical analysis (SPSS version 26).

Results: The patients were middle-aged with a male preponderance (67.9%; mean age, 31.41 ± 12.12 years). Greater RAPID scores were significantly related with old age, comorbidities, longer lengths of stay, and worse clinical outcomes (p < 0.05). Compared with the non-high-risk patients, the patients in the high-risk group had a significantly higher death rate and longer hospital stay.

Conclusion: The RAPID score is a good prognostic tool for patients with CPPPE and empyema. It closely correlates with age, comorbidities, length of hospital stay and outcome, justifying its place in early risk stratification and informed clinical decisions.