Evidence map›Paper›PMID 40884610›Full record

ArticleEuropean radiology2026

Pulmonary arterial blowout syndrome as a serious adverse event in patients with advanced lung cancer: a 12-year retrospective study.

Xu Ma, Xin Xu, Li Zhang, Jie Zhang, Di Zheng, Jian Ni, Jiying Wang, Xiaoxia Chen, Ruowang Duan, Dong Yu and 5 more

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Article in European radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

15 authors.

Xu Ma *Department of Radiology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.
Xin Xu *Department of Medical Affair, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.
Li Zhang *Department of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.
Jie ZhangDepartment of Oncology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.
Di ZhengDepartment of Oncology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.
Jian NiDepartment of Oncology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.
Jiying WangDepartment of Oncology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.
Xiaoxia ChenDepartment of Oncology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.
Ruowang DuanDepartment of Anesthesiology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.
Dong YuDepartment of Radiology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.
Bing JieDepartment of Radiology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.
Lingling LiDepartment of Radiology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.
Siwen SunDepartment of Radiology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.
Chunxia SuDepartment of Oncology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China. susu_mail@126.com.
Sen JiangDepartment of Radiology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China. jasfly77@vip.163.com.ORCID http://orcid.org/0000-0002-8605-3116

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveMassive haemoptysis due to central pulmonary artery (CPA) rupture in patients with advanced lung cancer is a fatal complication with limited early diagnostic tools. This study aimed to identify risk factors associated with pulmonary artery rupture and to propose a grading model to facilitate early diagnosis and timely endovascular intervention. MATERIALS AND

methodsThis retrospective study included patients with advanced lung cancer who experienced in-hospital sudden haemoptysis-related death and received endovascular treatment for CPA abnormalities. Propensity score matching (PSM; 1:2) balanced covariates between haemoptysis-related and other in-hospital deaths. Following PSM, multivariable logistic regression was performed to identify independent risk factors. Patients were categorised into two cohorts: Group A (2012-2018) and Group B (2019-2024), the latter reflecting the implementation of early detection and endovascular management. Overall survival (OS) was compared using Kaplan-Meier analysis and log-rank testing.

resultsAmong 886 in-hospital deaths, sudden haemoptysis accounted for 4.63% (41/886), with 90.24% (37/41) exhibiting CPA abnormalities. CPA abnormalities, tumour necrosis, cavitation, and progressive bloody or malodorous sputum were identified as significant risk factors (p < 0.05). The haemoptysis group had significantly shorter OS than controls (p < 0.001). A three-tier grading system for pulmonary arterial blowout syndrome (PABS) was developed, with acute PABS being the most prevalent (67.26%). Patients in Group B demonstrated significantly improved OS compared with Group A (p < 0.001).

conclusionThe PABS grading model enables risk stratification of life-threatening haemoptysis secondary to CPA rupture. Early identification and endovascular intervention may significantly improve clinical outcomes in advanced lung cancer. KEY POINTS: Question What are the clinical characteristics and risk stratification criteria for life-threatening haemoptysis arising from CPA rupture in advanced lung cancer? Findings In-hospital sudden haemoptysis mortality was 4.63% and strongly associated with CPA abnormalities. A PABS grading model characterises this fatal condition. Clinical relevance The PABS grading system enables early recognition of high-risk CPA rupture in advanced lung cancer. Prompt identification and endovascular intervention may substantially improve patient outcomes.

Indexed as

HemoptysisLung NeoplasmsPulmonary ArteryAgedFemaleHospital MortalityHumansMaleMiddle AgedRetrospective StudiesRisk FactorsRupture, SpontaneousSyndromeAdvanced lung cancerCentral pulmonary arterial abnormalityEndovascular treatmentHaemoptysisPulmonary arterial blowout syndrome

Identifiers

PMID40884610

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.