A Nomogram to Predict Recurrence After Bronchial Artery Embolization for Hemoptysis Due to Bronchiectasis.
Bronchiectasis
Embolization
Hemoptysis
Nomogram
Recurrence
therapeutic
Journal
Cardiovascular and interventional radiology
ISSN: 1432-086X
Titre abrégé: Cardiovasc Intervent Radiol
Pays: United States
ID NLM: 8003538
Informations de publication
Date de publication:
Oct 2021
Oct 2021
Historique:
received:
16
03
2021
accepted:
10
07
2021
pubmed:
21
7
2021
medline:
26
11
2021
entrez:
20
7
2021
Statut:
ppublish
Résumé
To develop and validate a nomogram for predicting recurrent hemoptysis after successful bronchial arterial embolization (BAE) in patients with bronchiectasis. From January 2015 to December 2019, a total of 251 patients were enrolled in this study. A nomogram was developed with the predictors of recurrent events, which were identified by univariate and multivariate Cox regression analyses. We evaluated nomogram discrimination by area under the receiver operating characteristic curve, calibration by the calibration curve, and clinical usefulness potential by decision curve analysis. The one-month, 1-year, 2-year, 3-year, and 5-year cumulative recurrence-free rates of patients were 98.4%, 90.5%, 82.8%, 77.7%, and 74.4%, respectively. Three predictive factors, namely sex, lung destruction, and systemic arterial-pulmonary circulation shunts, were applied to develop the nomogram. The model maintained good discrimination (area under the curve, 0.72; 95% confidence interval, 0.62-0.81), low prediction error (integrated Brier score, 0.129), and certain net benefits in terms of clinical usefulness. The proposed nomogram showed favorable predictive efficacy for hemoptysis recurrence after BAE in patients with bronchiectasis. Improved long-term outcomes are expected with close follow-up, a healthy lifestyle, and pulmonary rehabilitation for patients at risk of recurrence according to the model.
Identifiants
pubmed: 34282490
doi: 10.1007/s00270-021-02923-0
pii: 10.1007/s00270-021-02923-0
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1609-1617Subventions
Organisme : Jiangsu Province's Key Talents Program
ID : QNRC2016559
Organisme : Construction Program of Jiangsu Province Clinical Research Center Support System
ID : BL2014084
Informations de copyright
© 2021. Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).
Références
Quint JK, Smith MP. Paediatric and adult bronchiectasis: diagnosis, disease burden and prognosis. Respirology. 2019;24:413–22.
doi: 10.1111/resp.13495
Polverino E, Goeminne PC, McDonnell MJ, et al. European respiratory society guidelines for the management of adult bronchiectasis. Eur Respir J. 2017;50:1700629. https://doi.org/10.1183/13993003.00629-2017 .
doi: 10.1183/13993003.00629-2017
pubmed: 28889110
Tiddens H, Meerburg JJ, van der Eerden MM, et al. The radiological diagnosis of bronchiectasis: What’s in a name? Eur Respir Rev. 2020;29:190120. https://doi.org/10.1183/16000617.0120-2019 .
doi: 10.1183/16000617.0120-2019
pubmed: 32554759
Gao YH, Guan WJ, Liu SX, et al. Aetiology of bronchiectasis in adults: a systematic literature review. Respirology. 2016;21:1376–83.
doi: 10.1111/resp.12832
Pasteur MC, Bilton D, Hill AT. British thoracic society guideline for non-CF bronchiectasis. Thorax. 2010;65:577.
doi: 10.1136/thx.2010.142778
Qi Q, Wang W, Li T, et al. Aetiology and clinical characteristics of patients with bronchiectasis in a Chinese Han population: a prospective study. Respirology. 2015;20:917–24.
doi: 10.1111/resp.12574
Guan WJ, Gao YH, Xu G, et al. Aetiology of bronchiectasis in Guangzhou, southern China. Respirology. 2015;20:739–48.
doi: 10.1111/resp.12528
Visser SK, Bye P, Morgan L. Management of bronchiectasis in adults. Med J Aust. 2018;209:177–83.
doi: 10.5694/mja17.01195
Chalmers JD, Chang AB, Chotirmall SH, et al. Bronchiectasis. Nat Rev Dis Primers. 2018;4:45. https://doi.org/10.1038/s41572-018-0042-3 .
doi: 10.1038/s41572-018-0042-3
pubmed: 30442957
Nicotra MB, Rivera M, Dale AM, et al. Clinical, pathophysiologic, and microbiologic characterization of bronchiectasis in an aging cohort. Chest. 1995;108:955–61.
doi: 10.1378/chest.108.4.955
King PT, Holdsworth SR, Freezer NJ, et al. Characterisation of the onset and presenting clinical features of adult bronchiectasis. Respir Med. 2006;100:2183–9.
doi: 10.1016/j.rmed.2006.03.012
Olsen KM, Manouchehr-Pour S, Donnelly EF, et al. ACR appropriateness Criteria® Hemoptysis. J Am Coll Radiol. 2020;17:S148–59.
doi: 10.1016/j.jacr.2020.01.043
Kato A, Kudo S, Matsumoto K, et al. Bronchial artery embolization for hemoptysis due to benign diseases: immediate and long-term results. Cardiovasc Intervent Radiol. 2000;23:351–7.
doi: 10.1007/s002700010062
Lee JH, Kwon SY, Yoon HI, et al. Haemoptysis due to chronic tuberculosis vs bronchiectasis: comparison of long-term outcome of arterial embolisation. Int J Tuberc Lung Dis. 2007;11:781–7.
pubmed: 17609054
Chen J, Chen LA, Liang ZX, et al. Immediate and long-term results of bronchial artery embolization for hemoptysis due to benign versus malignant pulmonary diseases. Am J Med Sci. 2014;348:204–9.
doi: 10.1097/MAJ.0000000000000226
Lu GD, Zhang JX, Zhou CG, et al. Arterial embolization for hemoptysis in patients with chronic pulmonary tuberculosis and in patients with bronchiectasis. Acta Radiol. 2019;60:866–72.
doi: 10.1177/0284185118805258
Lu GD, Zu QQ, Zhang JX, et al. Risk factors contributing to early and late recurrence of haemoptysis after bronchial artery embolisation. Int J Tuberc Lung Dis. 2018;22:230–5.
doi: 10.5588/ijtld.17.0543
Chun JY, Belli AM. Immediate and long-term outcomes of bronchial and non-bronchial systemic artery embolisation for the management of haemoptysis. Eur Radiol. 2010;20:558–65.
doi: 10.1007/s00330-009-1591-3
Chalmers JD, Chotirmall SH. Bronchiectasis: new therapies and new perspectives. Lancet Respir Med. 2018;6:715–26.
doi: 10.1016/S2213-2600(18)30053-5
Raghavan D, Jain R. Increasing awareness of sex differences in airway diseases. Respirology. 2016;21:449–59.
doi: 10.1111/resp.12702
Xu S, Guan LJ, Shi BQ, et al. Recurrent hemoptysis after bronchial artery embolization: prediction using a nomogram and artificial neural network model. AJR Am J Roentgenol. 2020;215:1490–8.
doi: 10.2214/AJR.20.22775
Balachandran VP, Gonen M, Smith JJ, et al. Nomograms in oncology: more than meets the eye. Lancet Oncol. 2015;16:e173–80.
doi: 10.1016/S1470-2045(14)71116-7
Swanson KL, Johnson CM, Prakash UB, et al. Bronchial artery embolization: experience with 54 patients. Chest. 2002;121:789–95.
doi: 10.1378/chest.121.3.789
Panda A, Bhalla AS, Goyal A. Bronchial artery embolization in hemoptysis: a systematic review. Diagn Interv Radiol. 2017;23:307–17.
doi: 10.5152/dir.2017.16454
Yoon W, Kim YH, Kim JK, et al. Massive hemoptysis: prediction of nonbronchial systemic arterial supply with chest CT. Radiology. 2003;227:232–8.
doi: 10.1148/radiol.2271020324
Sayir F, Ocakcioglu I, Sehitogullari A, et al. Clinical analysis of pneumonectomy for destroyed lung: a retrospective study of 32 patients. Gen Thorac Cardiovasc Surg. 2019;67:530–6.
doi: 10.1007/s11748-018-01055-6
Davidson K, Shojaee S. Managing massive hemoptysis. Chest. 2020;157:77–88.
doi: 10.1016/j.chest.2019.07.012
Angle JF, Siddiqi NH, Wallace MJ, et al. Quality improvement guidelines for percutaneous transcatheter embolization: society of interventional radiology standards of practice committee. J Vasc Interv Radiol. 2010;21:1479–86.
doi: 10.1016/j.jvir.2010.06.014
van den Heuvel MM, Els Z, Koegelenberg CF, et al. Risk factors for recurrence of haemoptysis following bronchial artery embolisation for life-threatening haemoptysis. Int J Tuberc Lung Dis. 2007;11:909–14.
pubmed: 17705959
Ittrich H, Bockhorn M, Klose H, et al. The diagnosis and treatment of hemoptysis. Dtsch Arztebl Int. 2017;114:371–81.
pubmed: 28625277
pmcid: 5478790
Townsend EA, Miller VM, Prakash YS. Sex differences and sex steroids in lung health and disease. Endocr Rev. 2012;33:1–47.
doi: 10.1210/er.2010-0031
Seitz AE, Olivier KN, Steiner CA, et al. Trends and burden of bronchiectasis-associated hospitalizations in the United States, 1993–2006. Chest. 2010;138:944–9.
doi: 10.1378/chest.10-0099
Walker CM, Rosado-de-Christenson ML, Martinez-Jimenez S, et al. Bronchial arteries: anatomy, function, hypertrophy, and anomalies. Radiographics. 2015;35:32–49.
doi: 10.1148/rg.351140089
Deffebach ME, Charan NB, Lakshminarayan S, et al. The bronchial circulation. Small, but a vital attribute of the lung. Am Rev Respir Dis. 1987;135:463–81.
pubmed: 3544986
Yoon W, Kim JK, Kim YH, et al. Bronchial and nonbronchial systemic artery embolization for life-threatening hemoptysis: a comprehensive review. Radiographics. 2002;22:1395–409.
doi: 10.1148/rg.226015180
Wong C, Jayaram L, Karalus N, et al. Azithromycin for prevention of exacerbations in non-cystic fibrosis bronchiectasis (EMBRACE): a randomised, double-blind, placebo-controlled trial. Lancet. 2012;380:660–7.
doi: 10.1016/S0140-6736(12)60953-2
Serisier DJ, Martin ML, McGuckin MA, et al. Effect of long-term, low-dose erythromycin on pulmonary exacerbations among patients with non-cystic fibrosis bronchiectasis: the BLESS randomized controlled trial. JAMA. 2013;309:1260–7.
doi: 10.1001/jama.2013.2290