Impact of Hemoptysis Etiology and Embolic Agent Type on Prognosis in Patients Undergoing Bronchial Artery Embolization.

Abstract

Purpose To assess the impact of clinical factors, including hemoptysis etiology and embolic agent type, on the prognosis of patients with hemoptysis requiring bronchial artery embolization (BAE). Materials and Methods This retrospective cohort study used data from Japan's national administrative claims database (from January 2014 to December 2022). Patients with hemoptysis requiring BAE were identified using their corresponding diagnostic and procedural codes. Data extracted from the database included the etiology of hemoptysis and the types of embolic agents used. Survival rates after discharge from admission for BAE were assessed using Kaplan-Meier analysis. Independent prognostic factors were identified using multivariable Cox proportional analysis. Results The study included 7277 patients (mean age, 70.6 years ± 12.8 [SD]; 4074 male patients) with hemoptysis requiring BAE. The in-hospital mortality rate was 7.4%. Survival rates after discharge at 1, 3, and 5 years were 85.5%, 72.7%, and 64.4%, respectively. Use of coils as embolic agents was associated with a 17% lower incidence of all-cause mortality compared with use of gelatin sponge (hazard ratio [HR], 0.83 [95% CI: 0.74, 0.9], P = .002). Higher mortality was associated with bronchopulmonary carcinoma (HR, 2.59 [95% CI: 2.31, 2.89], P < .001), acute respiratory infection (HR, 1.26 [95% CI: 1.14, 1.39], P < .001), and chronic pulmonary aspergillosis (HR, 1.47 [95% CI: 1.28, 1.69], P < .001). Conclusion The prognosis of patients with hemoptysis requiring BAE was poor, especially in those with specific underlying etiologies. The use of coils versus gelatin sponge as the embolic agent for BAE was associated with improved survival. Keywords: Embolization, Vascular Supplemental material is available for this article © RSNA, 2025.