The prospective testing of the accuracy of a prognosis prediction score in pleural infection

胸膜感染描述了肺部和胸壁之间的感染液体积聚。每年约有80，000例新病例（美国+英国），其中35%是致命的或需要胸部手术。标准治疗包括抗生素和通过放置在胸部的管子引流感染的液体。如果失败，需要手术引流，但我们目前没有可靠的方法来确定哪些患者需要手术。及时的手术可能是挽救生命的需要的情况下，但它也与重大并发症，并导致大量的疼痛。因此，针对那些最需要的人进行手术非常重要。这项研究将测试一个预测工具，可以让我们确定？高风险？从手术中获益最多的人拟议的测试是在入院时计算的风险预测分数。以前的数据表明，从临床实践中常规收集的五种检测结果中预测死于胸膜感染的患者是可能的。虽然这些预测因素似乎非常强大，但它们需要在？真实的世界？使用.此外，其他工作表明，负责感染的细菌类型可能会预测死亡，这些因素也将尽可能进行探索？预测者？本研究将收集来自英国、欧洲、美国和远东的550例胸膜感染患者的信息。所有患者都将接受最好的治疗，包括抗生素、胸腔引流和必要的手术。我们将记录哪些病人死亡或需要手术。在研究结束时，我们将计算是否？预测者？识别高死亡风险的患者。进行这项研究的团队以前已经成功地完成了这一领域的许多研究。该研究团队拥有4500万临床研究资金。如果这里测试的分数被证明是一个很好的方法来预测哪些患者会表现得很差，这可以立即用来改变我们治疗这种疾病患者的方式。

Pleural infection describes infected fluid collecting between the lung and chest wall. There are around 80,000 new cases each year (US+UK), of which 35% are either fatal or require chest surgery. Standard treatment involves antibiotics and drainage of infected fluid, achieved through a tube placed in the chest. If this fails, surgical drainage is required, but we currently do not have a reliable way of identifying which patients will need surgery. Prompt surgery may be life saving in needy cases, but it is also associated with major complications and results in a substantial amount of pain. Thus, targeting surgery to those who need it most is important. This study will test a prediction tool which may allow us to identify ?high risk? who may benefit most from surgery. The proposed test is a risk prediction score calculated on admission to hospital. Previous data suggests it may be possible to predict patients who would die from their pleural infection from five test results which are routinely collected in clinical practice. While these predictors seem very powerful, they need to be tested in ?real world? use. In addition, other work suggests that the type of bacteria responsible for the infection may predict death, and these factors will also be explored as possible ?predictors?. This study will collect information about 550 pleural infection patients, recruited from UK, Europe, USA and the Far East. All patients will receive the best available treatment, including antibiotics, chest drainage and surgery if needed. We will record which patients die or need surgery. At the end of the study, we will calculate whether the ?predictors? identify patients at high risk of death.The team conducting this research have previously successfully completed many studies in this area. Together the research team holds #45m of clinical research funding. If the score tested here turns out to be a good way predict which patients will do badly, this can be immediately used to change how we treat patients with this disease.