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A Nomogram to Predict Recurrence After Bronchial Artery Embolization for Hemoptysis Due to Bronchiectasis

Abstract

Objective

To develop and validate a nomogram for predicting recurrent hemoptysis after successful bronchial arterial embolization (BAE) in patients with bronchiectasis.

Materials and Methods

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.

Results

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.

Conclusions

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.

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Funding

This study was funded by Jiangsu Province’s KeyTalents Program (QNRC2016559 to Qing-Quan Zu) and Construction Program of Jiangsu Province Clinical Research Center Support System (BL2014084 to Qing-Quan Zu).

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Correspondence to Qing-Quan Zu or Hai-Bin Shi.

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The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional (Ethical review no. 2018-SR-097) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this retrospective study, formal consent was not required.

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Cite this article

Yan, HT., Lu, GD., Huang, XZ. et al. A Nomogram to Predict Recurrence After Bronchial Artery Embolization for Hemoptysis Due to Bronchiectasis. Cardiovasc Intervent Radiol 44, 1609–1617 (2021). https://doi.org/10.1007/s00270-021-02923-0

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Keywords

  • Bronchiectasis
  • Embolization
  • therapeutic
  • Hemoptysis
  • Nomogram
  • Recurrence