Pleural infection presentation and timeline of events: Real-world data from a tertiary hospital in the UK

<bold>Background:</bold> Pleural infection remains a significant burden on mortality and morbidity in the Western world even with the advancement of clinical management. <bold>Objectives:</bold> This paper aims to study the clinical course of empyema thoracic patients managed in a tertiary hospital in the UK. <bold>Method:</bold> We did a retrospective observational study of the hospital's electronic records of patients who were diagnosed and managed for empyema thoracic from January 2021 to December 2022. <bold>Results:</bold> The total cohort was 104 empyema thoracic patients. The mean age was 60. The affected males were almost double than females (68 vs 36). We did a retrospective RAPID score of our cohort. The RAPID score could not be calculated for 35 patients due to the unavailability of pleural fluid data. High inpatient mortality (23%) was observed in the medium-risk (RAPID score 3-4) group and high 3-month mortality (25%) was observed in the high-risk (RAPID score 5-7) group. The majority of the patients were managed conservatively. No difference was noticed in the median length of hospital stay (11d) in all the risk groups. A high rate of (37%) surgical management was observed in the low-risk (RAPID score 0-2) group. <table-wrap><object-id>erj;64/suppl_68/PA5118/T1</object-id><object-id>T1</object-id><object-id>t1</object-id><table><colgroup><col></col><col></col><col></col><col></col><col></col></colgroup><tbody><tr><td>Variables</td><td>Low-risk group</td><td>Medium risk group</td><td>High-risk group</td><td>No RAPID score</td></tr><tr><td>Number of patients</td><td>35</td><td>30</td><td>4</td><td>35</td></tr><tr><td>Median LOS</td><td>11</td><td>11</td><td>11</td><td>11</td></tr><tr><td>Conservative Management</td><td>22(62%)</td><td>20(67%)</td><td>4(100%)</td><td>24(69%)</td></tr><tr><td>Surgical management</td><td>13(37%)</td><td>10(33%)</td><td>0</td><td>11(31%)</td></tr><tr><td>Inpatient mortality</td><td>2(6%)</td><td>7(23%)</td><td>0</td><td>4(11%)</td></tr><tr><td>90-day mortality</td><td>0</td><td>1(3%)</td><td>1(25%)</td><td>2(6%)</td></tr></tbody></table></table-wrap> <bold>Conclusion:</bold> Our cohort's data comply with the predicted mortality risk of the RAPID score. We emphasize that RAPID score calculation can be a significant tool in the management of empyema thoracic patients.