SynthesisIndian pediatrics2026
Predictors of Failure of Medical Management in Children with Empyema Thoracis: A Systematic Review.
Synthesis in Indian pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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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.
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.
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Who cites it
0 citing papers in PubMed.
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Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
contextChildren with empyema thoracis often respond to medical management, but some do not, and require surgical intervention. Prediction of failure of medical management will help to guide further management and plan surgical intervention.
objectiveTo systematically review literature for clinical, radiological, laboratory, or microbiological predictors, associated with failure of medical management or the need for surgery in children with empyema thoracis. EVIDENCE ACQUISITION: A systematic search was conducted in seven databases (PubMed, Embase, Cochrane Library, Scopus, Web of Science, ProQuest, and Open Grey) and four trial registries. Observational studies exploring predictors of treatment failure in empyema thoracis were eligible. Two reviewers independently screened the studies, extracted the data, and assessed the risk of bias. Data were analyzed in accordance with the review protocol.
resultsAmongst 12,311 citations identified, seven studies were included. One study identified three statistically significant predictors of medical treatment failure, viz. immediate ICU admission: OR (95%CI) 1.95 (1.18, 3.22); absence of complex septations on ultrasonography: 1.72 (1.21, 2.47); and positive blood culture: 2.8 (1.54, 5.07). Another study reported that "continuing pus discharge for ≥ 10 days after chest tube insertion" and "persistence of loculations on ultrasonography or CT scan despite fibrinolytic therapy" prompted surgical intervention. The presence of fever was identified as a significant predictor, although its duration and grade were not reported. The evidence had very low overall certainty, being limited by small, single-center, retrospective studies with heterogeneous designs, population, and outcome definitions, limiting generalizability.
conclusionsCurrent evidence did not identify any clinically meaningful predictors of the failure of medical management (or need for surgery) in children with empyema thoracis.
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Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.