Chinese Hemoptysis Registry Study (CHORE)

Background: Hemoptysis is one of the most common respiratory emergencies, with a mortality of over 75% for massive hemoptysis when untreated. Bronchial artery embolization and other vascular interventions have become first-line therapy, with immediate hemostasis rates of 70-99%. However, no nationwide standardized multicenter registry for hemoptysis exists in China; the epidemiological characteristics, etiology spectrum, individualized interventional strategies, long-term prognosis, and recurrence mechanisms of Chinese patients with hemoptysis remain unclear.

Objectives: (1) To describe the cross-sectional etiology spectrum and epidemiological characteristics of hemoptysis in China; (2) to evaluate the immediate and long-term efficacy of vascular interventional therapy, including immediate hemostasis success rate, clinical success rate, and long-term recurrence rate across different etiologies; (3) to identify independent risk factors for post-interventional recurrence using Cox regression and construct a nomogram prediction model; (4) to validate the clinical value of the "systemic-to-pulmonary shunt" hypothesis in interventional management of hemoptysis; (5) to provide high-quality evidence for standardization of interventional diagnosis and treatment of hemoptysis.

Methods: Consecutively hospitalized patients aged ≥18 years with active hemoptysis (>100 mL in a single episode or >300 mL/day) refractory to medical treatment, confirmed by chest CT/CTA, bronchoscopy, or angiography, and undergoing vascular interventional diagnosis and therapy will be enrolled. A minimum of 2500 patients will be enrolled over approximately 4 years (September 2026 to December 2030). Follow-up visits are scheduled at 1 and 3 months after discharge and every 6 months thereafter for at least 2 years, recording hemoptysis recurrence, intervention-related complications, all-cause and hemoptysis-specific death.

Inclusion criteria

• Age ≥18 years.
• Clinically confirmed active hemoptysis, with a pulmonary bleeding lesion verified by chest CT/CTA, bronchoscopy, or angiography.
• Hemoptysis volume >100 mL in a single episode or >300 mL per day, refractory to medical treatment.
• Undergoing vascular interventional diagnosis and therapy.
• Able to provide written informed consent and willing to participate voluntarily.

Exclusion criteria

• Concurrent participation in an interventional clinical trial of an investigational drug or novel interventional device.
• Missing contact information or inability to complete basic follow-up within 3 months (very high risk of loss to follow-up).
• Bleeding originating from the upper gastrointestinal tract (hematemesis) or upper respiratory tract (nasopharyngeal bleeding).
• Severe, uncorrectable coagulopathy that is an absolute contraindication to interventional procedures.
• Known allergy to iodinated contrast agents.
• Pregnancy or lactation.
• Severe hepatic or renal dysfunction precluding tolerance of interventional procedures.
• Any other condition judged by the investigator as inappropriate for participation.