Hemoptysis in adult patients: Etiology, recurrence and risk of mortality

Year 2023, , 451 - 458, 30.09.2023

Gülbahar Darılmaz Yüce , Elif Pınar Akarca , Başak Zeynep Güven , Oğuzcan Başkan , Mahmut Buğra Dulkar , Simay Engin , Şevval Ölmez , Şerife Torun , Uğur Toprak , Nazan Şen , Gaye Ulubay , M. Şule Akçay

https://doi.org/10.18663/tjcl.1252888

Abstract

Aim: The etiology of hemoptysis varies according to population differences, time, geographical region, and diagnostic tests used. The aim of this study is to investigate the etiological causes, recurrence and mortality risk of hemoptysis in a university hospital.
Materials and Methods: The data of 391 patients who applied to our hospital with hemoptysis between June 2011 and February 2022 were analyzed using the hospital electronic file system. Demographic characteristics, smoking information, radiological findings and related diagnoses of the patients were recorded. The obtained data were analyzed.
Results: A total of 391 patients, including 229 males and 162 females, were included in the study. The mean age of all patients was 54.5±20.0 years. Pneumonia (49.7%), lung cancer (21%), pulmonary embolism (17.8%) were the most common causes of hemoptysis. 48.5% of our cases had idiopathic hemoptysis. There was no difference between men and women in terms of diagnoses related to hemoptysis (p=0.937). The mean hemoptysis recurrence rate was 10.2% and the recurrence time was 375 days (min:6-max:2886) in all patients. The overall mortality rate was 6%. In the correlation analysis, only the length of stay in the first hemoptysis was found to be associated with mortality (p<0.05).
Conclusion: In our study; the overall mortality rate was 6%, and the risk of recurrence and mortality was high, and the risk of recurrence was higher in patients using anticoagulants or antiaggregants and in patients with lung cancer.

Keywords

Hemoptysis, etiology, recurrence, mortality

Supporting Institution

Başkent Üniversitesi Araştırma Fonu

Project Number

No:KA22/14 – 11.01.2022

Erişkin hastalarda hemoptizi: Etyoloji, rekürrens ve mortalite riski

Abstract

Amaç: Hemoptizinin etiyolojisi, popülasyon farklılıklarına, zamana, coğrafi bölgeye, kullanılan tanısal testlere göre değişmektedir. Bu çalışmanın amacı bir üniversite hastanesinde hemoptizinin etyolojik nedenlerini, rekürrens ve mortalite riskini araştırmaktır.
Gereç ve Yöntemler: Hastanemize Haziran 2011-Şubat 2022 tarihleri arasında hemoptizi nedeniyle başvuran 391 hastanın verileri hastane elektronik dosya sisteminden faydalanılarak incelendi. Hastaların demografik özellikleri, sigara kullanım bilgileri, radyolojik bulguları, ilişkili tanıları kaydedildi. Elde edilen veriler analiz edildi.
Bulgular: Çalışmaya 229 erkek 162 kadın olmak üzere 391 hasta dahil edildi. Tüm hastaların yaş ortalaması 54.5±20.0 idi. Pnömoni (%49.7), akciğer kanseri (%21), pulmoner emboli (%17.8) en sık hemoptizi nedenleriydi. Olgularımızın %48.5’i idiopatik hemoptiziydi. Hemoptiziyle ilişkili tanılar açısından kadın-erkek arasında farklılık saptanmadı (p=0.937). Tüm hastalarda ortalama hemoptizi rekkürrens oranı %10.2, rekürrens süresi 375 gün (min:6-max:2886) bulundu. Genel mortalite oranı %6 olup, Korelasyon analizinde sadece ilk hemoptizde yatış süresinin mortalite ile ilişkisi bulundu (p<0.05).
Sonuç: Çalışmamızda; genel mortalite oranı %6 bulunmuş olup, rekürrens ve mortalite riskinin yüksek olduğu, antikoagülan ya da antiagregan kullanan hastalarda ve akciğer kanseri tanılı hastalarda rekürrens riskinin daha yüksek olduğu görüldü.

Keywords

Hemoptizi, etyoloji, rekürrens, mortalite

Project Number

No:KA22/14 – 11.01.2022

References

• Ittrich H, Bockhorn M, Klose H, et al. The Diagnosis and Treatment of Hemoptysis. Dtsch Arztebl Int. 2017;114(21):371-381.
• Uzun O, Atasoy Y, Findik S, et al. A prospective evaluation of hemoptysis cases in a tertiary referral hospital. Clin Respir J. 2010;4(3):131-8.
• Earwood JS, Thompson TD. Hemoptysis: evaluation and management. Am Fam Physician. 2015;91(4):243-9.
• Abdulmalak C, Cottenet J, Beltramo G, et al. Haemoptysis in adults: a 5-year study using the French nationwide hospital administrative database. Eur Respir J 2015; 46: 503–11.
• Reisz G, Stevens D, Boutwell C, et al. The causes of hemoptysis revisited. A review of the etiologies of hemoptysis between 1986 and 1995. Mo Med. 1997;94(10):633-5.
• Fidan A, Ozdoğan S, Oruç O, et al. Hemoptysis: a retrospective analysis of 108 cases. Respir Med. 2002;96(9):677-80.
• Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin 2021; 71:209.
• Shibuya K, Inoue M, Lopez AD. Statistical modeling and projections of lung cancer mortality in 4 industrialized countries. Int J Cancer 2005; 117:476.
• Edwards BK, Brown ML, Wingo PA, et al. Annual report to the nation on the status of cancer, 1975-2002, featuring population-based trends in cancer treatment. J Natl Cancer Inst 2005; 97:1407.
• Ozgül MA, Turna A, Yildiz P, et al. Risk factors and recurrence patterns in 203 patients with hemoptysis. Tuberk Toraks. 2006;54(3):243-8.
• Unsal E, Köksal D, Cimen F, et al. Analysis of patients with hemoptysis in a reference hospital for chest diseases. Tuberk Toraks. 2006;54(1):34-42.
• TR. Ministry of Health Tuberculosis Diagnosis and Treatment Guide, Ankara, 2019. [citedSeptember11,2022.13].Availablefrom:https://hsgm.saglik.gov.tr/depo/birimler/tuberkuloz_db/haberler/Tuberkuloz_Tani_Ve_Tedavi_Rehberi_/Tuberkuloz_Tani_ve_Tedavi_Rehberi.pdf. Thirumaran M, Sundar R, Sutcliffe IM, et al. Is investigation of patients with haemoptysis and normal chest radiograph justified? Thorax. 2009;64(10):854-6.
• Chalumeau-Lemoine L, Khalil A, Prigent H, et al. Impact of multidetector CT-angiography on the emergency management of severe hemoptysis. Eur J Radiol. 2013;82(11):e742-7.
• Abid N, Loukil M, Mokni A, et al. Outcomes of bronchial artery embolization for the management of hemoptysis. Tunis Med. 2021;99(2):264-268.
• Kiral H, Evman S, Tezel C, et al. Pulmonary resection in the treatment of life-threatening hemoptysis. Ann Thorac Cardiovasc Surg. 2015;21(2):125-31.
• van den Heuvel MM, Els Z, Koegelenberg CF, et al. Risk factors for recurrence of haemoptysis following bronchial artery embolisation for life-threatening haemoptysis. Int J Tuberc Lung Dis. 2007;11(8):909-14.
• Hakan Koca H, Özden SŞ, Güldaval F, et al. Hemoptysıs: A Retrospectıve Analysıs Of 311 Cases. İzmir Göğüs Hastanesi Dergisi. 2008; 22(3): 65-71.
• Mondoni M, Carlucci P, Cipolla G, et al. Long-term prognostic outcomes in patients with haemoptysis. Respir Res. 2021;22(1):219.
• Ryuge M, Hara M, Hiroe T, et al. Mechanisms of recurrent haemoptysis after super-selective bronchial artery coil embolisation: a single-centre retrospective observational study. Eur Radiol. 2019;29(2):707-715.
• Menchini L, Remy-Jardin M, Faivre JB, et al. Cryptogenic haemoptysis in smokers: angiography and results of embolisation in 35 patients. Eur Respir J. 2009;34(5):1031-9.
• Cody O'Dell M, Gill AE, Hawkins CM. Bronchial Artery Embolization for the Treatment of Acute Hemoptysis. Tech Vasc Interv Radiol. 2017;20(4):263-265.