Development of a model to predict recurrence after bronchial artery embolization for non-cancer related hemoptysis

• Published in: BMC pulmonary medicine 2021-12, Vol.21 (1), p.419-419, Article 419
• Main Authors: Yan, Hai-Tao, Lu, Guang-Dong, Huang, Xiang-Zhong, Zhang, Da-Zhong, Ge, Kun-Yuan, Zhang, Jin-Xing, Liu, Jin, Liu, Sheng, Shi, Hai-Bin, Zu, Qing-Quan
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Bronchial Arteries; Calibration; Cancer; Care and treatment; Catheters; Cohort Studies; Diagnosis; Diseases; Embolization; Embolization, Therapeutic - adverse effects; Embolization, Therapeutic - methods; Embolization, Therapeutic - statistics & numerical data; Female; Health care; Hemoptysis; Hemoptysis - epidemiology; Hemoptysis - therapy; Humans; Lung diseases; Male; Medical imaging; Medical records; Middle Aged; Nomograms; Patients; Polyvinyl alcohol; Prediction models; Prognosis; Proportional Hazards Models; Pulmonology; Recurrence; Regression analysis; Relapse; Respiratory diseases; Risk Assessment; Risk factors; Shunts; Therapeutic; Therapeutic embolization; Tuberculosis; Variables; Veins & arteries
• ISSN: 1471-2466; 1471-2466
• DOI: 10.1186/s12890-021-01790-2

Relapse 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. The 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. One-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). The 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.