title: Pleural infection in a New Zealand centre: high incidence in Pacific people and RAPID score as a prognostic tool.
abstract: BACKGROUND
  Whilst there is an increase in incidence of pleural infection worldwide, there is a paucity of New Zealand data.
  
  
  OBJECTIVE
  This study looked at the epidemiology of pleural infection in a single New Zealand institution and evaluated the RAPID score as a prognostic tool.
  
  
  METHODS
  A retrospective review was performed on patients with pleural infection over a 3-year period. Pleural infection was defined as having clinical evidence of infection and fulfilling one of the following: (i) positive pleural fluid Gram stain or culture, (ii) frank pus, (iii) pH <7.2 or (iv) radiological evidence of complex effusion.
  
  
  RESULTS
  There were 108 patients; 76% were male, and mean age was 54 years. Two thirds of patients came from the most deprived areas. The dominant ethnic group was Pacific people (42%), which was twice as high as the Pacific population in the area (19%), P < 0.0001. After adjusting for deprivation, Pacific people were still over-represented, P = 0.0002. There were 14 deaths (13%), and these were associated with increasing age (P = 0.001) and urea (P = 0.007) but not ethnicity or socioeconomic deprivation. The RAPID score found that those in the high-risk (P = 0.026) and moderate-risk (P = 0.036) groups had significantly higher mortality compared with the low-risk group.
  
  
  CONCLUSIONS
  The over-representation of Pacific people with pleural infection is not fully explained by socioeconomic deprivation, highlighting other factors at play, such as genetic susceptibility. The RAPID score was of clinical utility in predicting mortality in our population.
authors.affiliation: Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
authors.forename: D
authors.initials: D
authors.lastname: Wong
authors.affiliation: Department of Respiratory Medicine, Middlemore Hospital, Auckland, New Zealand.
authors.forename: E
authors.initials: E
authors.lastname: Yap
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D010995:Pleural Diseases / Q000453:epidemiology* / Q000382:microbiology* / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D013908:Thoracotomy / Q000379:methods
chemical_list: D000900:Anti-Bacterial Agents
keywords: New Zealand; Pacific; RAPID; deprivation; pleural infection