Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
권호 표지
DOI QR코드

DOI QR Code

Analysis of Patients with Hemoptysis in a Tertiary Referral Hospital

  • Lee, Bo Ram (Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School) ;
  • Yu, Jin Yeong (Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School) ;
  • Ban, Hee Jung (Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School) ;
  • Oh, In Jae (Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School) ;
  • Kim, Kyu Sik (Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School) ;
  • Kwon, Yong Soo (Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School) ;
  • Kim, Yu Il (Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School) ;
  • Kim, Young Chul (Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School) ;
  • Lim, Sung Chul (Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School)
  • Received : 2012.02.20
  • Accepted : 2012.06.27
  • Published : 2012.08.30
Download PDF
⟨ Previous Next ⟩

Abstract

Background: This study attempted to investigate the main causes of hemoptysis, the type of examinations used for diagnosis, the treatment modalities and outcomes. Methods: A retrospective study was conducted on the medical records of 221 patients admitted to the Chonnam National University Hospital, between January 2005 and February 2010, with hemoptysis. Results: Bronchiectasis (32.6%), active pulmonary tuberculosis (18.5%), fungus ball (10.8%), and lung cancer (5.9%) accounted for most causes of hemoptysis. Computed tomography scan was the most sensitive diagnostic test when employed alone, with positive yield of 93.2%. There were 161 cases of conservative treatment (72.9%), 42 cases of bronchial artery embolization (BAE) (19.0%), and 18 cases of surgery (8.1%). Regarding the amount of hemoptysis, 70 cases, out of 221 cases, were mild (31.5%), 36 cases moderate (16.2%), and 115 cases massive hemoptysis (52.0%). Most of the patients were treated conservatively, but if there was more bleeding present, BAE or surgery was more commonly performed than the conservative treatment ($p{\leq}0.0001$). In the multivariate model, severe hemoptysis and lung cancer were independently associated with short-term recurrence. BAE was independently associated with long-term recurrence, and lung cancer was associated with in-hospital mortality. The overall in-hospital mortality rate was 11.3%. Conclusion: Hemoptysis is a common symptom with a good prognosis in most cases. However, patients exhibiting massive bleeding or those with malignancy had a poorer prognosis. In-hospital mortality was strongly related to the cause, especially in lung cancer.

Keywords

References

  1. Kim SK. Differential diagnosis of hemoptysis. Korean J Med 1998;55:634-41.
  2. Yoon W, Kim JK, Kim YH, Chung TW, Kang HK. Bronchial and nonbronchial systemic artery embolization for life-threatening hemoptysis: a comprehensive review. Radiographics 2002;22:1395-409.
  3. Knott-Craig CJ, Oostuizen JG, Rossouw G, Joubert JR, Barnard PM. Management and prognosis of massive hemoptysis: recent experience with 120 patients. J Thorac Cardiovasc Surg 1993;105:394-7.
  4. Santiago S, Tobias J, Williams AJ. A reappraisal of the causes of hemoptysis. Arch Intern Med 1991;151:2449-51.
  5. Fernando HC, Stein M, Benfield JR, Link DP. Role of bronchial artery embolization in the management of hemoptysis. Arch Surg 1998;133:862-6.
  6. Fidan A, Ozdogan S, Oruc O, Salepci B, Ocal Z, Caglayan B. Hemoptysis: a retrospective analysis of 108 cases. Respir Med 2002;96:677-80.
  7. Ayed A. Pulmonary resection for massive hemoptysis of benign etiology. Eur J Cardiothorac Surg 2003;24:689-93.
  8. Crocco JA, Rooney JJ, Fankushen DS, DiBenedetto RJ, Lyons HA. Massive hemoptysis. Arch Intern Med 1968;121:495-8.
  9. Erdogan A, Yegin A, Gurses G, Demircan A. Surgical management of tuberculosis-related hemoptysis. Ann Thorac Surg 2005;79:299-302.
  10. McCollun WB, Mattox KL, Guinn GA, Beall AC Jr. Immediate operative treatment for massive hemoptysis. Chest 1975;67:152-5.
  11. Kim SO, Oh IJ, Kim KS, Yu YK, Lim SC, Kim YC, et al. Recurrent hemoptysis after bronchial artery embolization. Tuberc Respir Dis 2001;51:364-72.
  12. Swanson KL, Johnson CM, Prakash UB, McKusick MA, Andrews JC, Stanson AW. Bronchial artery embolization: experience with 54 patients. Chest 2002;121:789-95.
  13. Chung WY, Byun MK, Park MS, Hahn CH, Kang SM, Lee DY, et al. Risk factors of recurrent hemoptysis after bronchial artery embolization. Tuberc Respir Dis 2006; 60:65-71.
  14. Remy J, Arnaud A, Fardou H, Giraud R, Voisin C. Treatment of hemoptysis by embolization of bronchial arteries. Radiology 1977;122:33-7.
  15. Yeo DS, Lee SY, Hyun DS, Lee SH, Kim SC, Choi YM, et al. Effect of bronchial artery embolization (BAE) in management of massive hemoptysis. Tuberc Respir Dis 1999;46:53-64.
  16. Abal AT, Nair PC, Cherian J. Haemoptysis: aetiology, evaluation and outcome: a prospective study in a third-world country. Respir Med 2001;95:548-52.
  17. Mayr B, Ingrisch H, Haussinger K, Huber RM, Sunder- Plassmann L. Tumors of the bronchi: role of evaluation with CT. Radiology 1989;172:647-52.
  18. Hirshberg B, Biran I, Glazer M, Kramer MR. Hemoptysis: etiology, evaluation, and outcome in a tertiary referral hospital. Chest 1997;112:440-4.
  19. Strickland B. Investigating haemoptysis. Br J Hosp Med 1986;35:242, 246-51.
  20. Brinson GM, Noone PG, Mauro MA, Knowles MR, Yankaskas JR, Sandhu JS, et al. Bronchial artery embolization for the treatment of hemoptysis in patients with cystic fibrosis. Am J Respir Crit Care Med 1998;157(6 Pt 1):1951-8.
  21. Mal H, Rullon I, Mellot F, Brugiere O, Sleiman C, Menu Y, et al. Immediate and long-term results of bronchial artery embolization for life-threatening hemoptysis. Chest 1999;115:996-1001.

Cited by

  1. Clinical Characteristics of Patients with Bronchioloalveolar Carcinoma: A Retrospective Study of 44 Cases vol.14, pp.7, 2012, https://doi.org/10.7314/apjcp.2013.14.7.4365
  2. Haemoptysis in adults: a 5-year study using the French nationwide hospital administrative database vol.46, pp.2, 2012, https://doi.org/10.1183/09031936.00218214
  3. The effects of signal transducer and activator of transcription three mutations on human platelets vol.29, pp.6, 2012, https://doi.org/10.1080/09537104.2017.1349309
  4. Management of severe hemoptysis vol.12, pp.10, 2018, https://doi.org/10.1080/17476348.2018.1507737
  5. Life-Threatening Hemoptysis in a Pediatric Referral Center vol.49, pp.3, 2021, https://doi.org/10.1097/ccm.0000000000004822
  6. Unusual cause of acute upper airway obstruction: spontaneous pharyngeal haematoma vol.14, pp.3, 2021, https://doi.org/10.1136/bcr-2021-242061
  7. Hemoptysis in Renal Transplant Recipients vol.28, pp.2, 2012, https://doi.org/10.15388/amed.2021.28.2.4
  8. A case of acute pulmonary embolism with severe haemoptysis vol.208, pp.None, 2012, https://doi.org/10.1016/j.thromres.2021.05.011