PURPOSE: Common etiologies for hemoptysis include inflammatory pulmonary disorders and bronchogenic carcinoma. Data is lacking on the causes and outcomes of hemoptysis in the unique inner city populations. The goal of the study was to evaluate causes of hemoptysis, diagnostic modalities and the outcome in this group of patients.
METHODS: Retrospectively review of all patients admitted with the diagnosis of hemoptysis between January 2006 and July 2009. Hemoptysis was defined as mild (less than 50 ml/24hrs), moderate (50-300ml/24hrs) and severe (>300 ml/24hr). Ninety-five cases were identified, 22 were excluded due to incomplete medical records.
RESULTS: Seventy-three patients with complete records were identified, 35(48%) males and 38(52%) females with an average age of 53 years (range19-88). Common co-morbidities were hypertension (60%), COPD (47%), HIV infection (26%), liver cirrhosis and chronic kidney diseases (7%). Fifty-seven (78%) patients had mild, 14(19%) had moderate and one patient had severe hemoptysis.All patients had chest-x-ray. Additionally, chest CT was performed in 46(63%); abnormal radiographic findings were found in 50 (68%) patients. Radiologic findings included unilateral/bilateral infiltrates (32%), mass (12%), others (24%) and normal (32%). Twenty-three (32%) patients underwent fiber-optic bronchoscopy and bleeding source was identified in 7(30%). The cause of hemoptysis was identified in 62 (85%) of cases. Bacterial pneumonia (29), acute bronchitis (10), tuberculosis (7), bronchiectasis (5) and malignancy (4) were the most common causes of hemoptysis. Bronchial embolization was done in two patients and thoracotomy in one for bleeding control. No patient died of hemoptysis.
CONCLUSION: Bacterial pneumonias, acute bronchitis and tuberculosis were the most common causes for hemoptysis. In distinction to other studies, majority of our patients had mild hemoptysis and tuberculosis as etiology was seen in 9.6% of our patients. In 41% of patients, CT revealed abnormalities not seen at chest-x-ray.
CLINICAL IMPLICATIONS: Tuberculosis is a common differential in our inner-city population with hemoptysis. CT chest is useful in patients with unclear etiology for hemoptysis despite normal chest-x-ray. The outcome for patients with mild/moderated hemoptysis is good.
DISCLOSURE: Venketraman Sahasranaman, No Financial Disclosure Information; No Product/Research Disclosure Information