Dataset Information

Pseudomonas aeruginosa isolation is an important predictor for recurrent hemoptysis after bronchial artery embolization in patients with idiopathic bronchiectasis: a multicenter cohort study.

ABSTRACT:

Background

Nearly half of bronchiectasis patients receiving bronchial artery embolization (BAE) still have recurrent hemoptysis, which may be life-threatening. Worse still, the underlying risk factors of recurrence remain unknown.

Methods

A retrospective cohort was conducted of patients with idiopathic bronchiectasis who received BAE from 2015 to 2019 at eight centers. Patients were followed up for at least 24 months post BAE. Based on the outcomes of recurrent hemoptysis and recurrent severe hemoptysis, a Cox regression model was used to identify risk factors for recurrence.

Results

A total of 588 individuals were included. The median follow-up period was 34.0 months (interquartile range: 24.3-53.3 months). The 1-month, 1-year, 2-year, and 5-year cumulative recurrent hemoptysis-free rates were 87.2%, 67.5%, 57.6%, and 49.4%, respectively. The following factors were relative to recurrent hemoptysis: 24-h sputum volume (hazard ratio [HR] = 1.99 [95% confidence interval [95% CI]: 1.25-3.15, p = 0.015]), isolation of Pseudomonas aeruginosa (HR = 1.50 [95% CI: 1.13-2.00, p = 0.003]), extensive bronchiectasis (HR = 2.00 [95% CI: 1.29-3.09, p = 0.002]), and aberrant bronchial arteries (AbBAs) (HR = 1.45 [95% CI: 1.09-1.93, p = 0.014]). The area under the receiver operating characteristic curve of the nomogram was 0.728 [95% CI: 0.688-0.769].

Conclusions

Isolation of Pseudomonas aeruginosa is an important independent predictor of recurrent hemoptysis. The clearance of Pseudomonas aeruginosa might effectively reduce the hemoptysis recurrence rate.

SUBMITTER: Wang LL

PROVIDER: S-EPMC10024824 | biostudies-literature | 2023 Mar

REPOSITORIES: biostudies-literature

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Publications

Pseudomonas aeruginosa isolation is an important predictor for recurrent hemoptysis after bronchial artery embolization in patients with idiopathic bronchiectasis: a multicenter cohort study.

Wang Le-Le LL Lu Hai-Wen HW Li Ling-Ling LL Gao Yong-Hua YH Xu Yu-Hua YH Li Hong-Xiao HX Xi Yun-Zhu YZ Jiang Fu-Sheng FS Ling Xue-Feng XF Wei Wei W Li Fa-Jiu FJ Mao Bei B Jiang Sen S Xu Jin-Fu JF

Respiratory research 20230318 1

<h4>Background</h4>Nearly half of bronchiectasis patients receiving bronchial artery embolization (BAE) still have recurrent hemoptysis, which may be life-threatening. Worse still, the underlying risk factors of recurrence remain unknown.<h4>Methods</h4>A retrospective cohort was conducted of patients with idiopathic bronchiectasis who received BAE from 2015 to 2019 at eight centers. Patients were followed up for at least 24 months post BAE. Based on the outcomes of recurrent hemoptysis and recu ...[more]

PMID: 36934266

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Project description:BackgroundHemoptysis is the most frequently reported complication of ultrasound-guided transthoracic needle lung biopsy (US-TTLB). However, factors influencing the occurrence of hemoptysis as a result of US-TTLB remain uncertain. Therefore, the aim of this study was to evaluate the incidence of hemoptysis as a complication of US-TTLB and to identify the related risk factors.MethodsWe retrospectively analyzed all data of patients who underwent US-TTLB from February 2013 through December 2016. The incidence, severity, and treatment of hemoptysis in each case were carefully recorded. Study variables were classified into patient-related factors (age, sex, smoking history, pulse oxygen saturation, laboratory tests and emphysema), biopsy-related factors (use of contrast agent, number of punctures and operators), and lesion-related factors (lesion location, size, pathology, length of puncture path and the grade of air bronchial sign). Univariate and multivariate logistic regression analyses were performed to analyze the risk factors of hemoptysis. We investigated whether incidence of hemoptysis increased according to increased grade of air bronchial sign by Mantel-Haenszel test.ResultsA total of 209 patients were evaluated. Hemoptysis occurred in 20 of the 209 patients (9.6%). In univariate analysis, the lesion pathology (P=0.037) and grade of air bronchial sign (P<0.001) were statistically significant factors between the hemoptysis group and the non-hemoptysis group. In multivariate analysis, the presence of multi-air bronchogram in sonographic image (odds ratio =8.946; 95% confidence interval: 2.873-27.863; P<0.001) was a statistically significant predictive risk factor for hemoptysis complicating US-TTLB. There was a significant tendency for incidence of hemoptysis with the grade of air bronchial sign (P<0.001).ConclusionsWe found that the rate of hemoptysis complicating US-TTLB was 9.6% and the severity of hemoptysis was not serious. Target lesion without air bronchogram is a safety sign, minor bronchogram means relatively low-risk, while multiple bronchogram is a highly dangerous ultrasound sign of hemoptysis.

Project description:BackgroundBronchial artery embolization (BAE) is a common and important way to manage hemoptysis. This study's purpose was to summarize the efficacy, safety, and related factors of BAE in the treatment of hemoptysis.MethodsFrom January 2010 to August 2023, a systematic literature search was conducted in PubMed, EMBASE, Web of Science, and Cochrane Library databases. Original studies with BAE for hemoptysis were included, with no restrictions on language. The outcomes of interest were technical success rate, clinical success rate, recurrence rate, mortality rate, and major complication rate. Pooled proportions with 95% confidence intervals (CIs) were calculated using random-effects models. The Newcastle-Ottawa Scale (NOS) was employed for quality assessment. Factors such as publication year, region, sample size, amount of hemoptysis, etiology, and embolization materials were extracted for subgroup analyses. Additionally, sensitivity analyses and test for publication bias were conducted.ResultsA total of 32 studies, including 6,032 patients, met our inclusion criteria. 27 studies were of high quality, while five of moderate quality. The results indicated the prevalence of technical success was 97.2% (95% CI: 95.1-98.8%) and 93.2% (95% CI: 90.3-95.7%) in clinical success. Hemoptysis recurrence and mortality rates after BAE were 24.8% (95% CI: 20.5-29.4%) and 2.3% (95% CI: 1.1-3.8%), respectively. Moreover, the pooled prevalence of major complication was 0.1% (95% CI: 0.0-0.4%). Subgroup analysis revealed that studies published after 2017 demonstrated a higher technical success rate and a lower recurrence rate. Massive hemoptysis showed a higher technical success rate but a lower clinical success rate. BAE also demonstrated superior efficacy in patients with bronchiectasis. The clinical success rate was significantly higher in patients with benign diseases than those with malignancies. Gelatin sponge (GS) showed poor embolization efficacy. N-butyl-2-cyanoacrylate (NBCA) and coils exhibited reduced recurrence rates, while NBCA displayed an even lower recurrence rate than non-absorbable particles. The study by Ishikawa et al. influenced the stability of the pooled major complication rate, and the sensitivity analysis confirmed the robustness of the remaining results.ConclusionsBAE is safe and effective in treating different degrees of hemoptysis caused by benign and malignant lesions. Promising clinical efficacy was observed with NBCA as an embolic material for the treatment of hemoptysis. However, further conclusions should be investigated using evidence-based medicine.

Dataset Information

Pseudomonas aeruginosa isolation is an important predictor for recurrent hemoptysis after bronchial artery embolization in patients with idiopathic bronchiectasis: a multicenter cohort study.

Background

Methods

Results

Conclusions

Publications

Pseudomonas aeruginosa isolation is an important predictor for recurrent hemoptysis after bronchial artery embolization in patients with idiopathic bronchiectasis: a multicenter cohort study.

Similar Datasets

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