Abstract
BackgroundRelapse after effective bronchial arterial embolization (BAE) for controlling hemoptysis is not uncommon. Studies reported diverse predictors of recurrence. However, a model to assess the probability of recurrence in non-cancer related hemoptysis patients after BAE has not been reported. This study was to develop a model to predict recurrence after BAE for non-cancer related hemoptysis.MethodsThe study cohort included 487 patients who underwent BAE for non-cancer-related hemoptysis between January 2015 and December 2019. We derived the model’s variables from univariate and multivariate Cox regression analyses. The model presented as a nomogram scaled by the proportional regression coefficient of each predictor. Model performance was assessed with respect to discrimination and calibration.ResultsOne-month and 1-, 2-, 3- and 5-year recurrence-free rates were 94.5%, 88.0%, 81.4%, 76.2% and 73.8%, respectively. Risk factors for recurrence were underlying lung diseases and the presence of systemic arterial-pulmonary circulation shunts. This risk prediction model with two risk factors provided good discrimination (area under curve, 0.69; 95% confidence interval, 0.62–0.76), and lower prediction error (integrated Brier score, 0.143).ConclusionThe proposed model based on routinely available clinical and imaging features demonstrates good performance for predicting recurrence of non-cancer-related hemoptysis after BAE. The model may assist clinicians in identifying higher-risk patients to improve the long-term efficacy of BAE.
Highlights
Roughly 70% of hemoptysis is caused by respiratory diseases unrelated to cancer [1,2,3]
Complication and recurrence Minor complications occurred in 80 patients, including fever in 36, chest or shoulder discomfort in 30, abdominal discomfort or vomiting in 10, puncture site hematoma in two, headache in one, and anaphylaxis in one patient
Results from our study showed bronchial arterial embolization (BAE) was highly effective in controlling hemoptysis, with 2-year and 5-year recurrence-free rates of 81.4% and 73.8%, respectively
Summary
70% of hemoptysis is caused by respiratory diseases unrelated to cancer [1,2,3]. Bronchial arterial embolization (BAE) is highly effective in controlling hemoptysis. Pre-procedure CT imaging and angiographic findings were assessed for their predictive capability [4]. Those studies did not fully integrate the clinical and imaging features nor determine their individual contributions to predicting recurrent bleeding. Relapse after effective bronchial arterial embolization (BAE) for controlling hemoptysis is not uncom‐ mon. A model to assess the probability of recurrence in non-cancer related hemoptysis patients after BAE has not been reported. This study was to develop a model to predict recurrence after BAE for non-cancer related hemoptysis
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