ISRCTN ISRCTN50236700
DOI https://doi.org/10.1186/ISRCTN50236700
Secondary identifying numbers Version 1.0 20/03/2013
Submission date
20/03/2013
Registration date
20/05/2013
Last edited
22/06/2021
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Respiratory
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
This observational study aims to determine the capacity of baseline clinical and biological parameters and an associated prediction model (RAPID score) to predict mortality from pleural infection (infection of the membrane that enfolds the lungs).

Who can participate?
Patients diagnosed with a pleural infection will be invited to participate.

What does the study involve?
This study has been specifically designed to collect clinical and biological data - for example, the results of blood tests and pleural fluid analysis, and physical observations such as blood pressure, chest X-rays, chest ultrasound scans, lung function testing - in patients with diagnosed pleural infection. We hope that by analysing these results a diagnostic tool (or prediction score) can be developed that will help doctors in the future identify which patients with pleural infection are at higher or lower risk of serious problems or complications. This will hopefully help doctors choose the best treatment options for their patients.

What are the possible benefits and risks of participating?
We hope that every patient in the study will benefit, as normal, from the treatment they receive for their pleural infection as well as the opportunity for regular and continued follow-up appointments and assessments. Participation in the study will not however entitle patients to receive any specific or specialist treatment that they might not otherwise have access to. When the study is completed, we hope that the information collected from those individuals who choose to participate will help us to improve the treatment of patients with pleural infection in the future. Pleural infection itself and the different methods of treating it have their own associated risks and complications, but none of these are affected by participation in this study. Patients will have at least three chest x-rays during their participation, although many of these would need to be done whether you were in the study or not. There are some theoretical health risks from excessive radiation exposure, but chest x-rays are considered one of the safest tests as the dose from one is only equivalent to around four days' worth of normal background radiation.

Where is the study run from?
The study is being led and co-ordinated by the Oxford Respiratory Trials Unit based at the Churchill Hospital, Oxford, United Kingdom.

When is the study starting and how long is it expected to run for?
In total, 500/600 patients from hospitals around the world will participate in this study over an approximate three year period starting in 2013.

Who is funding the study?
Medical Research Council (UK).

Who is the main contact?
Mrs Emma Hedley
emma.hedley@ouh.nhs.uk

Contact information

Dr Najib Rahman
Scientific

Oxford Respiratory Trials Unit
Oxford Centre for Respiratory Medicine
Churchill Hospital
Old Road
Headington
Oxford
OX3 7LE
United Kingdom

Email emma.hedley@ouh.nhs.uk

Study information

Study designObservational cohort study
Primary study designObservational
Secondary study designCohort study
Study setting(s)Hospital
Study typeDiagnostic
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titleThe Pleural Infection Longitudinal Outcome Study: an observational cohort study
Study acronymPILOT
Study objectivesAn observation study to ascertain the capacity of baseline clinical and biological parameters and an associated prediction model (RAPID score) to predict mortality from pleural infection at 3 months.
Ethics approval(s)NRES Committee South Central - Oxford B, 11/07/2013, REC ref: 13/SC/0204
Health condition(s) or problem(s) studiedPleural Infection
InterventionDemographics, details of clinical history and past medical history, drug history including antibiotic use within the last 4 weeks and baseline clinical observations, as recorded in normal clinical care. Baseline blood parameters (e.g. full blood count, inflammatory markers, renal function) and measurement of pleural fluid parameters (protein, glucose, LDH and pH if not purulent fluid, standard pleural fluid microbiology), chest X-ray and 10mL (0.3floz) of blood and 20mL (0.6floz) of pleural fluid will be obtained at enrolment into the study and stored in individual local centres.

Patients will be followed up at 3 and 12 months post trial entry.
Intervention typeOther
Primary outcome measureThe primary outcome of this study is the capability of the prediction score (RAPID) to predict mortality from pleural infection at 3 months.

The PILOT study is intended to ascertain the capacity of baseline clinical and biological parameters and an associated prediction model (RAPID score) to predict key clinical outcomes including mortality from pleural infection. These include renal indices, age, purulence of pleural fluid, infection source and albumin measured at baseline.
Secondary outcome measuresThe secondary outcomes of this study are the capability of baseline clinical indices and the prediction score (RAPID) to predict the following:
1. Mortality from pleural infection at 12 months
2. Duration of hospital (in-patient) stay
3. Necessity for surgical fluid drainage over 12 months
4. Failure of medical treatment
5. Residual lung function impairment at 3 months
Overall study start date01/05/2013
Completion date31/10/2017

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participants550
Total final enrolment546
Key inclusion criteriaAdult patients, both male and female, aged 18 years or over with pleural infection as diagnosed by standard and internationally-accepted criteria as follows:
1. A clinical presentation compatible with pleural infection, AND
2. A pleural fluid collection that may or (rarely, according to clinical judgement) may not require drainage that meets at least one or more of the following criteria:
2.1. Purulent
2.2. Gram stain positive for bacteria
2.3. Bacterial culture positive
2.4. Acidic with a pH <7.2
2.5. Low pleural fluid glucose <3mmol/L (<40mg/dL)
2.6. CT evidence of pleural infection (consolidation of underlying lung with enhancing pleural collection on contrast-enhanced CT)
Key exclusion criteria1. Age <18 years
2. No pleural fluid available for analysis
3. Previous pneumonectomy on the side of pleural infection
4. Expected survival <3 months due to co-morbid disease
5. Inability to give informed consent
Date of first enrolment01/05/2013
Date of final enrolment01/01/2017

Locations

Countries of recruitment

  • Australia
  • Belgium
  • England
  • Singapore
  • United Kingdom
  • United States of America

Study participating centre

Oxford Respiratory Trials Unit
Oxford
OX3 7LE
United Kingdom

Sponsor information

University of Oxford (UK)
University/education

Oxford University Hospitals NHS Trust
Joint Research Office
Block 60
Churchill Hospital
Oxford
OX3 7LE
England
United Kingdom

Email ctrg@admin.ox.ac.uk
Website http://www.ox.ac.uk/
ROR logo "ROR" https://ror.org/052gg0110

Funders

Funder type

Research council

Medical Research Council
Government organisation / National government
Alternative name(s)
Medical Research Council (United Kingdom), UK Medical Research Council, MRC
Location
United Kingdom

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 26/11/2020 10/12/2020 Yes No
HRA research summary 28/06/2023 No No

Editorial Notes

22/06/2021: PubMed address added.
10/12/2020: The following changes were made to the trial record:
1. Publication reference added.
2. The total final enrolment was added.
09/04/2018: Overall trial end date was changed from 01/01/2017 to 31/10/2017.