Abstract Rationale Pediatric empyema is a common complication of pneumonia with significant morbidity, yet the current literature lacks comprehensive tools that capture outcomes from the perspective of children and their caregivers. Existing outcome assessments focus on healthcare worker-reported outcomes, neglecting broader domains such as quality of life and the patient/caregiver experience. Methods We conducted a systematic review of PubMed, Embase, and CINAHL. Eligible studies included patients with empyema that reported patient-, caregiver-, or parent-reported outcome measures (PROMs); patient-reported experience measures (PREMs); including pain measures. We initially focused on the pediatric setting (i.e. children aged ≤18 years) and excluded articles if outcomes were adult-only or if pediatric data could not be isolated. Adult focused studies were later revisited to look for additional insights into use of PROMs and PREMs and their content if used in this setting. Two independent reviewers screened titles/abstracts and full texts, with conflicts resolved by a third reviewer. Data extraction included outcome domains, measurement tools, and respondents (child vs proxy). Results Of the 856 abstracts screened, 14 full-text articles were retrieved. Only one contained pediatric-specific PROMs/PREMs, 12 were adult-focused, and the remaining study was excluded due to the wrong indication (terminal malignancy, n = 1). The pediatric study reported only on perioperative pain outcomes using a visual analog/smiley faces scale, and caregiver/nurse proxy reporting. In the adult-specific studies, a range of PROMs were reported (e.g., pain, dyspnea, quality of life) (n = 12). However, the literature did not discuss whether these tools were developed with patient consultation. Risk of bias assessment and meta-analysis were not performed due to the inclusion of only one study; instead, findings are described qualitatively. No studies addressed health-related quality of life, functional outcomes, or direct patient experience. This systematic review has been registered on PROSPERO (CRD420251182385). Conclusions This systematic review highlights an urgent need for validated, child-centered PROMs and PREMs in pediatric empyema studies and management. Current literature is limited across both pediatric and adult age ranges to proxy-assessed pain, with significant gaps in patient experience, functional recovery, and quality of life. Co-development tools involving children and families are essential to support patient-centered research and care in empyema. This abstract is funded by: None
Haynes et al. (2026) studied this question.