RAPID Score for Pleural Infection
Predicts 3-month mortality in patients with pleural infection (empyema/complicated parapneumonic effusion) to guide management intensity. Validated in the MIST2 trial cohort.
Score interpretation
RAPID 0–2: Low risk group. ~3% 3-month mortality.
→ Standard pleural drainage + antibiotics. Consider outpatient management with indwelling pleural catheter if appropriate. Respiratory review.
RAPID 3–4: Intermediate risk.
→ Inpatient management. Chest drain ± intrapleural tPA+DNase (MIST2 protocol). Respiratory medicine. Surgical review if not resolving in 5–7 days.
RAPID 5–7: High risk. Nearly 50% 3-month mortality.
→ Urgent aggressive management. Early VATS/surgical decortication. Intrapleural fibrinolytics. Nutritional support. Goals-of-care discussion.
Interpretation bands for the RAPID Score. Apply clinical judgement and local guidance.
References
- Rahman NM, et al. A clinical score (RAPID) to identify those at risk for poor outcome at presentation in patients with pleural infection. Chest. 2014;145(4):848–855.
Related
Curated clinical cross-links plus same-class fallbacks.
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- COPD Exacerbation Management · NICE NG115 / GOLD 2024
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.