바로가기메뉴

본문 바로가기 주메뉴 바로가기

Tuberculosis & Respiratory Diseases

Article Contents

Prev Next
e-Submission

Vol.73 No.2
Citation Share

Analysis of Patients with Hemoptysis in a Tertiary Referral Hospital

Tuberculosis & Respiratory Diseases / Tuberculosis & Respiratory Diseases,
2012, v.73 no.2, pp.107-114


Jin Yeong Yu (Chonnam National University Medical School)
Hee Jung Ban (Chonnam National University Medical School)





Jin, Y. Y. , Hee, J. B. , & (2012). Analysis of Patients with Hemoptysis in a Tertiary Referral Hospital. Tuberculosis & Respiratory Diseases, 73(2), 107-114.
  • Downloaded
  • Viewed
PDF Download

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≤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
Hemoptysis, Etiology, Diagnosis, Therapeutics, Treatment Outcome

Reference

1.

1. Kim SK. Differential diagnosis of hemoptysis. Korean J Med 1998;55:634-41.

2.

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.

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.

4. Santiago S, Tobias J, Williams AJ. A reappraisal of the causes of hemoptysis. Arch Intern Med 1991;151:2449- 51.

5.

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.

6. Fidan A, Ozdoğan S, Oruç O, Salepçi B, Ocal Z, Cağlayan B. Hemoptysis: a retrospective analysis of 108 cases. Respir Med 2002;96:677-80.

7.

7. Ayed A. Pulmonary resection for massive hemoptysis of benign etiology. Eur J Cardiothorac Surg 2003;24: 689-93.

8.

8. Crocco JA, Rooney JJ, Fankushen DS, DiBenedetto RJ, Lyons HA. Massive hemoptysis. Arch Intern Med 1968; 121:495-8.

9.

9. Erdogan A, Yegin A, Gürses G, Demircan A. Surgical management of tuberculosis-related hemoptysis. Ann Thorac Surg 2005;79:299-302.

10.

10. McCollun WB, Mattox KL, Guinn GA, Beall AC Jr. Immediate operative treatment for massive hemoptysis. Chest 1975;67:152-5.

11.

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.

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.

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.

14. Rémy J, Arnaud A, Fardou H, Giraud R, Voisin C. Treatment of hemoptysis by embolization of bronchial arteries. Radiology 1977;122:33-7.

15.

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.

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.

17. Mayr B, Ingrisch H, Häussinger K, Huber RM, Sunder- Plassmann L. Tumors of the bronchi: role of evaluation with CT. Radiology 1989;172:647-52.

18.

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.

19. Strickland B. Investigating haemoptysis. Br J Hosp Med 1986;35:242, 246-51.

20.

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.

21. Mal H, Rullon I, Mellot F, Brugière 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.

Tuberculosis & Respiratory Diseases

e-Submission OA Policy