Abstract

Objective: The treatment of pleural empyema (PE) includes antibiotics, pleural drainage, and surgical intervention; however, the optimal timing for surgery remains controversial. This study evaluates the outcomes of surgical decortication in PE and the correlation between RAPID classification and surgical results.
Methods: A retrospective case series was conducted on 47 PE patients who underwent decortication at the University Medical Center, Ho Chi Minh City, from January 2019 to December 2023.
Results: Chest pain was the most common reason for admission (51.1%), and pneumonia was the leading cause (61.7%). Stage III PE accounted for 55.32% of cases. Most patients were classified as moderate RAPID (63.8%). RAPID classification was associated with treatment outcomes. Patients with moderate-to-high RAPID scores had longer hospital stays (p<0.002) and more complications than those with low scores. Among patients with moderate-to-high RAPID scores, early surgery reduced complications compared to delayed surgery (p<0.031). The 3-month mortality rate was 6.4%.
Conclusion: The RAPID score aids in risk stratification and predicting surgical outcomes in PE. Early surgery may benefit patients with moderate-to-high RAPID scores.