Lung Cancer: Lung Cancer I |

Predictors of Lung Cancer in Patients Presenting With Hemoptysis FREE TO VIEW

Sunkaru Touray, MBChB; Jisoo Lee, MD; Scott Kopec, MD
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University of Massachusetts Medical School, Worcester, MA

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):696A. doi:10.1016/j.chest.2016.08.791
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SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM

PURPOSE: Hemoptysis is a clinical symptom characterized by the expectoration of blood from the respiratory tract. Its variable causes range from benign infections of the lung, bronchiectasis, to lung cancer. The evaluation of hemoptysis presents a clinical challenge because while most frequently reported causes are benign, recent studies have shown that about 4 % of such patients will develop lung cancer. We present findings of a 5-year retrospective review of patients seen by providers across all specialties in our medical system, reporting on the prevalence of lung cancer and factors associated with diagnosis.

METHODS: 547 adult patients seen by the providers in our medical system were identified by querying ambulatory medical records for ICD code 786.30 (Hemoptysis) between January 2010 and July 2015. Demographic information, medical history, and medication lists were identified for each patient. Lung cancer was identified by searching for ICD codes for lung cancer (162.9, V16.1). Chi-squared test was used to compare percentages, while mean values ± SD are reported for quantitative variables. All tests are two tailed and a p-value of less than or equal to 0.05 was considered significant. Multivariate logistic regression was used to determine predictors of lung cancer diagnosis reporting odds ratios (OR) and their 95% confidence intervals (CI), using the backward elimination method.

RESULTS: Mean age was 59 years, two thirds were male; more than half of patients were current or former smokers (56.7%). Smoking status was not documented in 17% of patients. Lung cancer was the most common malignancy among study participants with a prevalence of 7.3%, followed by breast cancer (4.4%), colon cancer (3.5%), and prostate cancer (2.7%), respectively. Bronchitis, both acute and chronic, was present in 5.7 % of patients. Pulmonary embolism was prevalent in 2.6 % of patients. In multivariate analyses, age ≥ 65 (adjusted OR 2.3, p = 0.04), male gender (adjusted OR 2.5, p = 0.05) and history of diabetes (adjusted OR 2.7, p = 0.03) were associated with statistically significant increased odds of having lung cancer among patients seen. There was also a trend toward and increased odds in patients with COPD although this did not achieve statistical significance (adjusted OR 2.2, p = 0.06).

CONCLUSIONS: Lung cancer is the most prevalent cancer seen in patients presenting with hemoptysis in a tertiary academic medical center with older age, male gender and diabetes being associated with a higher odd of having this malignancy.

CLINICAL IMPLICATIONS: Elderly males older than 65 with a history of diabetes, and who are current or former smokers presenting with hemoptysis have a higher odds of having lung cancer and therefore should undergo evaluation with a veiw to exclude this diagnosis.

DISCLOSURE: The following authors have nothing to disclose: Sunkaru Touray, Jisoo Lee, Scott Kopec

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