eng Science and Education Publishing American Journal of Infectious Diseases and Microbiology 2328-4064 2025-08-25 13 3 51 55 10.12691/ajidm-13-3-2 AJIDM20251332 article Abishek Ravichandran 1 Saka Vinod Kumar vinoddayamani@hotmail.com 1 Manju R 1 Rakhi Biswas 2 Sharbari Basu 3 Department of Pulmonary Medicine, Jawaharlal Institute of PostgraduateMedical Education and Research (JIPMER), Puducherry, India Department of Microbiology, Jawaharlal Institute of PostgraduateMedical Education and Research (JIPMER), Puducherry, India Department of Biochemistry, Jawaharlal Institute of PostgraduateMedical Education and Research (JIPMER), Puducherry, India Background: Empyema is a serious pleural infection with significant morbidity and mortality. The RAPID score is a validated tool for early risk stratification. This study aimed to evaluate the prognostic value of the RAPID score in adult empyema patients in a tertiary care setting. Methods: A prospective observational study was conducted on 61 adult patients with confirmed empyema. RAPID scores were assigned at admission to stratify patients into low (0¨C2), medium (3¨C4), and high (5¨C7) risk groups. Clinical features, microbiological profile, radiological findings, need for surgery, hospital stay, and 3-month mortality were recorded and analysed. Results:Most patients were male (82%) and aged <50 years (52.5%). Diabetes (42.6%) and tuberculosis (26.2%) were prevalent; Pseudomonas aeruginosa (19.7%) was the most common isolate. RAPID scores classified 65.6% as low risk, 29.5% as medium, and 4.9% as high. Unadjusted analysis showed higher mortality in medium-risk vs. low-risk groups (27.8% vs. 5%; p = 0.026), with no deaths in the high-risk group. On multivariable logistic regression, medium risk had higher but non-significant odds of mortality (aOR 8.03; 95% CI 0.61¨C105.13; p = 0.112); subgroup analysis suggested a stronger association in non-TB empyema (aOR 13.67; p = 0.061). Only age was independently associated with mortality (p = 0.014). RAPID score was not associated with hospital stay or surgical intervention. Conclusion: The RAPID score is a useful bedside tool for predicting short-term mortality in empyema, particularly in medium-risk patients, though it does not predict hospital stay or surgical need. Age was the strongest individual predictor of mortality. https://pubs.sciepub.com/ajidm/13/3/2/ajidm-13-3-2.pdf Empyema RAPID score Pleural infection Mortality prediction Surgical intervention