Treatment of non-severe hemoptysis: A retrospective propensity score-matched comparison between conservative...

This study aimed to compare the effectiveness of hemoptysis control between patients managed conservatively and early bronchial artery embolization (BAE), and to identify clinical factors associated with recurrence.

Patients with underlying malignancy, massive hemoptysis, or incomplete clinical data were excluded. 320 patients with non-severe hemoptysis were included (210 conservative, 110 BAE). Propensity scores were estimated using baseline variables including age, sex, comorbidities, and radiologic findings. Hemoptysis-free survival (HFS) was the primary outcome. Cox proportional hazards regression was used to assess associations between clinical and radiological factors and HFS.

Before PSM, radiological finding of post-tuberculous residual changes and cavitary lesion were more prevalent in the BAE group (22.7 % vs. 13.3 %, p = 0.032; 12.7 % vs. 5.7 %, p = 0.029, respectively).After PSM, 110 matched pairs showed balanced baseline variables. Clinical success rates were 94.5 % in the conservative group and 97.3 % in the BAE group (p = 0.496). In the PSM cohort, HFS did not differ significantly between groups (p = 0.304). Diabetes mellitus (DM) was the only independent predictor of recurrence (HR 2.615, 95 % CI 1.288-5.306, p = 0.008). Patients with DM had significantly shorter HFS (p = 0.003).

Conservative management and BAE showed comparable outcomes in non-severe hemoptysis of benign etiology. Diabetes mellitus was an independent predictor of recurrence, and BAE served effectively as rescue therapy after conservative treatment failure.