Evidence map›Paper›PMID 41676182›Full record

ArticleAME case reports2026

Successful two-port video-assisted thoracoscopic surgery for acute empyema in a high-risk patient with a high RAPID score: a case report.

Yuki Fujimoto, Masahiro Yanagiya, Ami Wada, Yoshiaki Furuhata, Jun Nakajima

Abstract readCase Reports
In one paragraph

Article in AME case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Yuki FujimotoDepartment of Thoracic Surgery, Japanese Red Cross Medical Center, Tokyo, Japan.
Masahiro YanagiyaDepartment of Thoracic Surgery, The University of Tokyo Graduate School of Medicine, Tokyo, Japan.ORCID https://orcid.org/0000-0001-8907-7538
Ami WadaDepartment of Thoracic Surgery, Japanese Red Cross Medical Center, Tokyo, Japan.
Yoshiaki FuruhataDepartment of Thoracic Surgery, Japanese Red Cross Medical Center, Tokyo, Japan.
Jun NakajimaDepartment of Thoracic Surgery, Japanese Red Cross Medical Center, Tokyo, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Acute empyema presents a significant mortality risk in advanced-age populations, with rates reaching up to 20% in patients over 80 years of age. While initial treatment typically involves antibiotics and thoracic drainage, surgical intervention is often necessary in stage II empyema due to multiloculation and inadequate drainage. The renal (urea), age, fluid purulence, infection source, dietary (albumin) (RAPID) score has been proposed as both a prognostic tool and a potential surgical indicator, but its role in high-risk patients remains uncertain. Case Description: An 85-year-old male nursing home resident with an Eastern Cooperative Oncology Group performance status of 3 and comorbidities including type 2 diabetes, chronic kidney disease stage 3b, and cardiovascular history presented with fever and cough. Chest computed tomography revealed encapsulated pleural effusion with multiloculation, consistent with acute stage II empyema secondary to aspiration pneumonia. Initial antibiotic therapy and thoracic drainage were ineffective. Despite high-risk conditions and a RAPID score of 6, semi-elective two-port video-assisted thoracoscopic surgery (VATS) decortication was performed. Postoperative recovery was uneventful, and the patient was discharged on day 13 without complications. Conclusions: This case highlights that VATS can be a viable and safe treatment option for acute empyema, even in high-risk older adults with a high RAPID score, provided clinical stability and appropriate disease staging.

Indexed as

case reportEmpyemapleural infectionrenal (urea), age, fluid purulence, infection source, dietary (albumin) score (RAPID score)video-assisted thoracoscopic surgery (VATS)

Identifiers

PMID41676182
PMCPMC12885831

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