European journal of radiology · 2025
Treatment of non-severe hemoptysis: A retrospective propensity score-matched comparison between conservative management and bronchial artery embolization.
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Kim Kun Yung, Yoon Chang Jin, Lee Jae Hwan, Lee Chong-Ho, Min Hooney Daniel
Аннотация
OBJECTIVE: This study aimed to compare the effectiveness of hemoptysis control between patients managed conservatively and early bronchial artery embolization (BAE), and to identify clinical factors associated with recurrence.
METHODS: Patients with underlying malignancy, massive hemoptysis, or incomplete clinical data were excluded. 320 patients with non-severe hemoptysis were included (210 conservative, 110 BAE). Propensity scores were estimated using baseline variables including age, sex, comorbidities, and radiologic findings. Hemoptysis-free survival (HFS) was the primary outcome. Cox proportional hazards regression was used to assess associations between clinical and radiological factors and HFS.
RESULTS: Before PSM, radiological finding of post-tuberculous residual changes and cavitary lesion were more prevalent in the BAE group (22.7 % vs. 13.3 %, p = 0.032; 12.7 % vs. 5.7 %, p = 0.029, respectively).After PSM, 110 matched pairs showed balanced baseline variables. Clinical success rates were 94.5 % in the conservative group and 97.3 % in the BAE group (p = 0.496). In the PSM cohort, HFS did not differ significantly between groups (p = 0.304). Diabetes mellitus (DM) was the only independent predictor of recurrence (HR 2.615, 95 % CI 1.288-5.306, p = 0.008). Patients with DM had significantly shorter HFS (p = 0.003).
CONCLUSION: Conservative management and BAE showed comparable outcomes in non-severe hemoptysis of benign etiology. Diabetes mellitus was an independent predictor of recurrence, and BAE served effectively as rescue therapy after conservative treatment failure.
METHODS: Patients with underlying malignancy, massive hemoptysis, or incomplete clinical data were excluded. 320 patients with non-severe hemoptysis were included (210 conservative, 110 BAE). Propensity scores were estimated using baseline variables including age, sex, comorbidities, and radiologic findings. Hemoptysis-free survival (HFS) was the primary outcome. Cox proportional hazards regression was used to assess associations between clinical and radiological factors and HFS.
RESULTS: Before PSM, radiological finding of post-tuberculous residual changes and cavitary lesion were more prevalent in the BAE group (22.7 % vs. 13.3 %, p = 0.032; 12.7 % vs. 5.7 %, p = 0.029, respectively).After PSM, 110 matched pairs showed balanced baseline variables. Clinical success rates were 94.5 % in the conservative group and 97.3 % in the BAE group (p = 0.496). In the PSM cohort, HFS did not differ significantly between groups (p = 0.304). Diabetes mellitus (DM) was the only independent predictor of recurrence (HR 2.615, 95 % CI 1.288-5.306, p = 0.008). Patients with DM had significantly shorter HFS (p = 0.003).
CONCLUSION: Conservative management and BAE showed comparable outcomes in non-severe hemoptysis of benign etiology. Diabetes mellitus was an independent predictor of recurrence, and BAE served effectively as rescue therapy after conservative treatment failure.