Massive Hemoptysis: A Meta-Analysis of Urgent Interventional Approaches
DOI:
https://doi.org/10.37275/bsm.v9i5.1272Keywords:
Bronchial artery embolization, Bronchoscopy, Massive hemoptysis, Meta-analysis, SurgeryAbstract
Background: Massive hemoptysis is a life-threatening medical emergency requiring immediate intervention. This meta-analysis evaluated the efficacy and safety of urgent interventional approaches for managing massive hemoptysis.
Methods: A systematic search of electronic databases (PubMed, Embase, Scopus) was conducted from January 2013 to February 2024. Studies comparing different urgent interventional approaches (bronchial artery embolization [BAE], bronchoscopic interventions, surgery) in adults with massive hemoptysis were included. The primary outcome was treatment success (cessation of bleeding). Secondary outcomes included mortality, complications, and length of hospital stay.
Results: Nine studies (n=1145 patients) were included. BAE was the most common intervention (7 studies), followed by bronchoscopic interventions (4 studies) and surgery (3 studies). Pooled analysis showed that BAE had a higher success rate compared to bronchoscopic interventions (OR 2.15, 95% CI 1.32-3.51, p=0.002) and surgery (OR 1.88, 95% CI 1.15-3.08, p=0.01). BAE was associated with a lower mortality rate compared to surgery (OR 0.43, 95% CI 0.21-0.88, p=0.02) but not bronchoscopic interventions (OR 0.78, 95% CI 0.45-1.35, p=0.37). Complication rates were similar across all interventions.
Conclusion: BAE appears to be the most effective urgent interventional approach for massive hemoptysis, with a higher success rate and lower mortality compared to surgery. Bronchoscopic interventions may be considered in selected cases. Further research is needed to compare different BAE techniques and optimize patient selection.
Authors
- Bambang Rojullun Taufik1*
- Russilawati2
- Dewi Wahyu Fitrina2
- 1Resident of Pulmonology and Respiratory Medicine, Universitas Andalas/Dr. M. Djamil General Hospital, Padang, Indonesia
- 2Department of Pulmonology and Respiratory Medicine, Universitas Andalas/Dr. M. Djamil General Hospital, Padang, Indonesia
Corresponding author Bambang Rojullun Taufik — bambangrojulluntaufik@yahoo.com
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