Hai-Tao Yan1, Guang-Dong Lu1, Xiang-Zhong Huang2, Da-Zhong Zhang3, Kun-Yuan Ge4, Jin-Xing Zhang1, Jin Liu5, Sheng Liu1, Qing-Quan Zu6, Hai-Bin Shi7. 1. Department of Interventional Radiology, The First Affiliated Hospital With Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China. 2. Department of Interventional Radiology, Jiangyin People's Hospital, Wuxi, 214400, China. 3. Department of Interventional Radiology, Jiangsu Taizhou People's Hospital, Taizhou, 225300, China. 4. Department of Interventional Radiology, Yixing People's Hospital, Wuxi, 214200, China. 5. Department of Clinical Medicine Research Institution, The First Affiliated Hospital With Nanjing Medical University, Nanjing, 210029, China. 6. Department of Interventional Radiology, The First Affiliated Hospital With Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China. zuqingquan@njmu.edu.cn. 7. Department of Interventional Radiology, The First Affiliated Hospital With Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China. shihb@njmu.edu.cn.
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.
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.
Authors: James D Chalmers; Anne B Chang; Sanjay H Chotirmall; Raja Dhar; Pamela J McShane Journal: Nat Rev Dis Primers Date: 2018-11-15 Impact factor: 52.329
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Authors: Eva Polverino; Pieter C Goeminne; Melissa J McDonnell; Stefano Aliberti; Sara E Marshall; Michael R Loebinger; Marlene Murris; Rafael Cantón; Antoni Torres; Katerina Dimakou; Anthony De Soyza; Adam T Hill; Charles S Haworth; Montserrat Vendrell; Felix C Ringshausen; Dragan Subotic; Robert Wilson; Jordi Vilaró; Bjorn Stallberg; Tobias Welte; Gernot Rohde; Francesco Blasi; Stuart Elborn; Marta Almagro; Alan Timothy; Thomas Ruddy; Thomy Tonia; David Rigau; James D Chalmers Journal: Eur Respir J Date: 2017-09-09 Impact factor: 16.671