Screening and diagnosis

Classification and risk stratification

Perioperative care

Quality improvement

Patient education

Nonpharmacologic interventions

Therapeutic procedures

Respiratory support

Follow-up and surveillance

Specific circumstances

Preventative measures

Medical management

Surgical interventions

Inpatient care

Diagnostic procedures

Diagnostic investigations

Insufficient evidence to make a recommendation.

Strongly favor this test or intervention.

The RAPID score calculator is designed to assess the risk of 3-month mortality in patients with pleural infections. It uses five input variables: blood urea nitrogen, age, purulence of pleural fluid, infection source, and serum albumin levels. Each input corresponds to predefined categorical options that are assigned specific numerical scores based on clinical findings, allowing the calculator to estimate the risk level.

The scoring system for each input variable is as follows:

1. Blood Urea Nitrogen:
   - Less than 14 mg/dL [5 mmol/L]: 0 points
   - Between 14-23 mg/dL [5-8 mmol/L]: 1 point
   - Greater than 23 mg/dL [8 mmol/L]: 2 points

2. Age (years):
   - Less than 50: 0 points
   - Between 50-70: 1 point
   - Greater than 70: 2 points

3. Purulence of Pleural Fluid:
   - Purulent: 0 points
   - Non-purulent: 1 point

4. Infection Source:
   - Community-acquired: 0 points
   - Hospital-acquired: 1 point

5. Serum Albumin:
   - Equal to or greater than 2.7 g/dL [27 g/L]: 0 points
   - Less than 2.7 g/dL [27 g/L]: 1 point

To compute the total RAPID score, each input answer is converted into a score using the system outlined above, and the scores are summed together. The maximum possible score is 7, while the minimum possible score is 0. Based on the total score, risk of mortality within 3 months is categorized into one of three levels:

- A total score of 2 or less indicates a low risk of 3-month mortality.
- A total score between 3 and 4 indicates a medium risk of 3-month mortality.
- A total score of 5 or more indicates a high risk of 3-month mortality.

The RAPID score is a clinical calculator used for patients with pleural infection. RAPID stands for Renal function, Age, Purulence, Infection source, and Dietary status. This scoring system is used to predict the mortality risk in patients with pleural infection, helping clinicians to stratify patients based on their risk and guide treatment decisions.

The RAPID score is applicable to patients diagnosed with pleural infection, regardless of the underlying cause. It is not suitable for patients without a confirmed diagnosis of pleural infection or those with pleural effusion due to non-infectious causes. The score may also be less accurate in patients with multiple comorbidities or complex medical histories that could independently affect the variables included in the score.

RAPID score for pleural infection

Parapneumonic effusion and empyema

Indications for surgery

Indications for surgery (general principles)

Intrapleural saline irrigation

Pleural fluid drainage

Pleural fluid drainage, tube thoracostomy, technical considerations

Diagnostic imaging

Pleural fluid analysis

Laboratory tests

Pleural fluid drainage (thoracoscopy and surgical drainage)

Antibiotic therapy

Pediatric patients

Pediatric patients (evaluation)

Patients with bronchopleural fistulas

Risk assessment

Pleural fluid culture

Patients with chronic empyema

Pediatric patients (antibiotic therapy)

Intrapleural fibrinolytic therapy

Follow-up

Pediatric patients, drainage and fibrinolytic therapy

Indications for surgery, video-assisted thoracoscopic surgery

Indications for evaluation

Pediatric patients (monitoring)

Pleural fluid drainage (tube thoracostomy, indications)

Patients with postresectional empyema

Indications for surgery (decortication)

Parapneumonic effusion and empyema

Guidelines

Key sources