دورية أكاديمية
A Clinical Score (RAPID) to Identify Those at Risk for Poor Outcome at Presentation in Patients With Pleural Infection
| العنوان: | A Clinical Score (RAPID) to Identify Those at Risk for Poor Outcome at Presentation in Patients With Pleural Infection |
|---|---|
| المؤلفون: | Rahman, NM, Kahan, BC, Miller, RF, Gleeson, FV, Nunn, AJ, Maskell, NA |
| المصدر: | Chest , 145 (4) pp. 848-855. (2014) |
| بيانات النشر: | AMER COLL CHEST PHYSICIANS |
| سنة النشر: | 2014 |
| المجموعة: | University College London: UCL Discovery |
| مصطلحات موضوعية: | Critical Care Medicine, Respiratory System, Assisted Thoracoscopic Surgery, Parapneumonic Effusions, Surgical-treatment, Childhood Empyema, Thoracic Empyema, Randomized-trial, Management, Decortication, Debridement, Guideline |
| الوصف: | BACKGROUND: Pleural infection is associated with a high morbidity and mortality. Development of a validated clinical risk score at presentation to identify those at high risk of dying would enable patient triage and may help formulate early management strategies. METHODS: A clinical risk score was derived based on data from patients entering the multicenter UK pleural infection trial (first Multicenter Intrapleural Sepsis Trial [MIST1], n = 411). From 22 baseline clinical characteristics, model selection was undertaken to find variables predictive of poor clinical outcome. Outcomes were mortality at 3 months (primary), need for surgical intervention at 3 months, and time from randomization to discharge. The derived scoring system RAPID (renal, age, purulence, infection source, and dietary factors) was validated using patients enrolled in the subsequent MIST2 trial (n = 191). RESULTS: Age, urea, albumin, hospital-acquired infection, and nonpurulence predicted poor outcome. Patients were stratified into low-risk (0-2), medium-risk (3-4), and high-risk (5-7) groups. Using the low-risk group as a reference, a RAPID score of 3 to 4 and > 4 was associated with an OR of 24.4 (95% CI, 3.1-186.7; P = .002) and 192.4 (95% CI, 25.0-1480.4; P < .001), respectively, for death at 3 months. In the validation cohort (MIST2), a medium-risk RAPID score was nonsignificantly associated with mortality (OR, 3.2; 95% CI, 0.8-13.2; P = .11), and a high-risk score was associated with increased mortality (OR, 14.1; 95% CI, 3.5-56.8; P < .001). Hospitalization duration was associated with increasing RAPID score (score 0-2: median duration = 7, interquartile range 6-13; score > 5: median duration = 15, interquartile range 9-28, P = .08). CONCLUSIONS: The RAPID score may permit risk stratification of patients with pleural infection at presentation. |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | text |
| اللغة: | English |
| العلاقة: | https://discovery.ucl.ac.uk/id/eprint/1430484/1/Rahman_a_clinical_score_%28RAPID%29_to_identifyAAM.pdfTest; https://discovery.ucl.ac.uk/id/eprint/1430484Test/ |
| الإتاحة: | https://discovery.ucl.ac.uk/id/eprint/1430484/1/Rahman_a_clinical_score_%28RAPID%29_to_identifyAAM.pdfTest https://discovery.ucl.ac.uk/id/eprint/1430484Test/ |
| حقوق: | open |
| رقم الانضمام: | edsbas.18A80B65 |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |