Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2020 Oct;48(10):1480-1486.
doi: 10.1097/CCM.0000000000004513.

Early Arterial Embolization and Mortality in Mechanically Ventilated Patients With Hemoptysis: A Nationwide Retrospective Cohort Study

Takahiro Ando  1   2 , Masahiro Kawashima  2 , Taisuke Jo  1   3 , Kimihiko Masuda  2 , Yasuhiro Yamauchi  1 , Goh Tanaka  1 , Hidenori Kage  1 , Maho Suzukawa  2 , Hideaki Nagai  2 , Hiroki Matsui  4 , Kiyohide Fushimi  3 , Hideo Yasunaga  4 , Takahide Nagase  1
Affiliations
Multicenter Study

Early Arterial Embolization and Mortality in Mechanically Ventilated Patients With Hemoptysis: A Nationwide Retrospective Cohort Study

Takahiro Ando et al. Crit Care Med. 2020 Oct.

Abstract

Objectives: Hemoptysis, a symptom common across various respiratory diseases, can cause airway obstruction leading to a life-threatening condition. Arterial embolization has been used to control bleeding from the lower airways. However, limited studies have evaluated its effects on in-hospital mortality in patients with hemoptysis requiring mechanical ventilation. The objective of this study was to clarify whether early intervention by arterial embolization reduced mortality in mechanically ventilated patients with hemoptysis.

Design: Retrospective cohort study from July 2010 to March 2017.

Setting: More than 1,200 acute-care hospitals, comprising approximately 90% of all tertiary-care emergency hospitals in Japan.

Patients: The study cohort was patients with pulmonary diseases hospitalized for hemoptysis and mechanically ventilated within 2 days of admission.

Interventions: We compared patients who had undergone arterial embolization within 3 days of endotracheal intubation (early embolization group) with patients who did not (control group).

Measurements and main results: A total of 12,287 patients with hemoptysis requiring mechanical ventilation were analyzed. After 1:4 propensity score matching, there were 226 and 904 patients in the early embolization and control groups, respectively. The early embolization group was associated with lower 7-day and 30-day mortalities (7-d mortality: 1.3% vs 4.0%; odds ratio, 0.39; 95% CI, 0.16-0.97; p = 0.044 and 30-d mortality: 7.5% vs 16.8%; odds ratio, 0.45; 95% CI, 0.28-0.73; p = 0.001) and shorter duration of mechanical ventilation (median 6 d, interquartile range 4-13 d vs 8 d, interquartile range 4-19 d; p = 0.003) compared with the control group.

Conclusions: Our results show that early intervention by arterial embolization may be effective in reducing 7-day and 30-day mortalities in patients with life-threatening hemoptysis requiring mechanical ventilation.

PubMed Disclaimer

Comment in

References

    1. Hirshberg B, Biran I, Glazer M, et al. Hemoptysis: Etiology, evaluation, and outcome in a tertiary referral hospital. Chest 1997; 112:440–444
    1. Sakr L, Dutau H. Massive hemoptysis: An update on the role of bronchoscopy in diagnosis and management. Respiration 2010; 80:38–58
    1. Jean-Baptiste E. Clinical assessment and management of massive hemoptysis. Crit Care Med 2000; 28:1642–1647
    1. Mal H, Rullon I, Mellot F, et al. Immediate and long-term results of bronchial artery embolization for life-threatening hemoptysis. Chest 1999; 115:996–1001
    1. Abdulmalak C, Cottenet J, Beltramo G, et al. Haemoptysis in adults: A 5-year study using the French nationwide hospital administrative database. Eur Respir J 2015; 46:503–511

Publication types

MeSH terms

LinkOut - more resources