Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Long-Term Survival Benefit of the Bronchial Arterial Embolization for Patients Presenting with Non-Traumatic Hemoptysis in a District Emergency Center

권역 응급의료센터에 내원한 비외상성 객혈 환자에서 기관지 동맥 색전술의 장기 생존 효과

  • Chon, Song Bin (Department of Emergency Medicine, Seoul National University College of Medicine) ;
  • Jung, Sung Koo (Department of Emergency Medicine, Seoul National University College of Medicine) ;
  • Kwak, Young Ho (Department of Emergency Medicine, Seoul National University College of Medicine) ;
  • Suh, Gil Joon (Department of Emergency Medicine, Seoul National University College of Medicine) ;
  • You, Eun Young (Department of Emergency Medicine, Seoul National University Boramae Hospital) ;
  • Shin, Sang Do (Department of Emergency Medicine, Seoul National University Boramae Hospital)
  • 천성빈 (서울대학교 의과대학 응급의학교실) ;
  • 정성구 (서울대학교 의과대학 응급의학교실) ;
  • 곽영호 (서울대학교 의과대학 응급의학교실) ;
  • 서길준 (서울대학교 의과대학 응급의학교실) ;
  • 유은영 (서울대학교 보라매병원 응급의학과) ;
  • 신상도 (서울대학교 보라매병원 응급의학과)
  • Received : 2004.05.10
  • Accepted : 2004.07.15
  • Published : 2004.08.30
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Abstract

Background : This study was conducted to evaluate the survival benefit of the bronchial arterial embolization (BAE) for patients presenting with non-traumatic hemoptysis. Methods : The clinical data were retrospectively collected from the medical records and the Order Communicating Systems (OCS). The information dealing with death was collected from national death certificates. After enrolled patients were divided with two group such as BAE group (patients who were managed with BAE) and non-BAE group (patients who were managed with conservative modality), the survival benefit of BAE was estimated during the observational period of 24 months through using the Kaplan-Meier survival graph and the Cox-proportional hazard regression analysis. Results : The number of total cases was 272. Of these, BAE group involved 63 and non-BAE group involved 209. 69 cases had the malignant pulmonary lesions, 149 cases had non-malignant chronic lung lesion such as the mycobacteria infection, fungus ball, or bronchiectasis (BE), and 54 cases had the other pathologic conditions. For each sub-groups such as 'malignant lung lesion' group, 'non-malignant chronic lung lesion' group as well as about all cases, the adjusted hazard ratios (HRs) of BAE for death was not significantly different compared to the conservative management. But the adjusted HRs as to underlying causes such as 'malignant lung lesion' group and 'the other conditions' group increased significantly compared to 'non-malignant chronic lung lesion' group. Conclusion : There was no significant survival benefit by BAE procedure on survival in patients presenting with non-traumatic hemoptysis.

연구 배경 : 본 연구는 비외상성 객혈을 주소로 내원한 환자에서 기관지 동맥 색전술의 생존 효과를 파악하고자 시행하였다. 방 법 : 환자에 대한 임상적인 정보는 의무기록, 전자처방기록(Order Communication System), 방사선 기록 등을 통하여 수집하였으며, 사망 관련 정보는 통계청 사망 자료를 통하여 획득하였다. 전체 환자를 최대 2년 동안 관찰하였으며, 기관지 동맥 시행 여부에 따라 시행군과 비시행군 등 두 군으로 나누어 관련 요인별로 생존과 사망에 대한 단변량 분석을 시행하였다. 기관지 동맥 색전술 시행 여부로 층화하여 Kaplan-Meier 생존곡선을 구한 후, 관련 요인을 보정하여 Cox-proportio-nal hazard regression analysis를 시행하여 기관지 동맥 색전술에 따른 생존 효과를 평가하였다. 결 과 : 대상 환자는 총 272명으로 이 중 기관지 동맥 색전술을 시행 받은 환자는 63명, 시행 받지 않은 환자는 209명이었으며, 원인 질환별로 악성 폐종양군은 69명, 양성 만성 폐질환군은 149명, 기타 질환군은 54명이었고 이 중 2년 이내에 사망한 경우는 69명이었다. 전체 환자를 대상으로, 그리고 악성 폐종양군, 양성 만성 질환군 등 세부 군을 대상으로 기관지 동맥 색전술의 생존효과를 평가하였을 때, 유의한 결과를 보여주지 않았다. 결 론 : 2년 동안의 관찰 기간 동안, 비외상성 객혈환자에서 기관지 동맥 색전술은 유의한 생존 효과를 보여주지 못하였다.

Keywords

References

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