To determine etiology, prognosis and relationship between severity and etiology in-patients presenting with hemoptysis.
A retrospective analysis of 101 patients admitted with hemoptysis at Coney Island Hospital between 2000-2002 for etiology, prognosis and relation between etiology and severity of hemoptysis. Hemoptysis was classified as mild (<30ml), moderate (30-100ml), severe (100-600ml) and massive (>600ml) based on 24 hours collection. Chest X-ray findings were noted.
Of the 101 cases 66 were men and 35 were women, 49.6 was mean age. 88(87.1%) patients had mild hemoptysis, 10 (9.9%) patients moderate, 1(0.99%) patient severe and 3 (2.97%) patients had massive hemoptysis. In 49/101(48.5%) patient’s chest x-ray finding was inconclusive to establish etiology and in only four (8.16%) of these patient further work up establish a diagnosis in form of laryngeal cancer in three patients and laryngeal ulcer in one patient. Bronchitis (39.6%), cancer (13.8%), pneumonia (10.8%), bronchiectasis (8.9%), pulmonary tuberculosis (7.9%), coagulopathy (3.9%) accounted for most of causes of hemoptysis. All but one of these patient’s with a diagnosis had mild to moderate hemoptysis. 39/40 (97.5%) patient with bronchitis had mild hemoptysis and 3/4 (75%) patients with sever to massive hemoptysis no etiology was found and chest x-ray was inconclusive. All patients with hemoptysis survived.CONCLUSIONS: Airway disease like bronchitis and bronchiectasis continue to be the commonest cause of hemoptysis. Majority patients had mild hemoptysis and prognosis was good. The severity of hemoptysis was not a good indicator of the underlying etiology. Even in the patients with severe & massive hemoptysis etiology was not established despite extensive work up. Patients with hemoptysis and in conclusive chest x-ray and chest CT scan show low yield on further work up.
In-patient presenting with hemoptysis with non-diagnostic chest x-ray and chest CT scan further work up for etiology carries low yield and should be done only for specific purpose.
D.P. Malli, None.