[Etiology of hemoptysis: Prospective analysis of 752 cases]

To know the etiology of hemoptysis and its distribution in our area compared with other current and historic series.

Prospective, descriptive study of 752 cases of hemoptysis. The etiology of these cases was determined by evaluating the clinical record, chest X-ray, functional respiratory tests and sputum smear for acid-fast bacilli, together with other examinations such as bronchoscopy and computerized tomography (CT) according to previously established criteria.

The mean age of patients was 60 years (SD: 15 years), 79% were males and 75% smokers. Diagnoses included neoplasms (28%), chronic bronchitis (19.8%), bronchiectasis (14.5%), pneumonia or lung abscess (11.5%), idiopathic forms (8%), and miscellaneous causes with lower percentages such as tuberculosis (1.7%) and its sequelae (4%), cardiac diseases (1.5%) and pulmonary embolism (2.3%). Bronchoscopy was performed in 694 (92.2%) and detected the bleeding site or provided a specific diagnosis in 39% (81% if only neoplasms are considered) and non-specific but abnormal in 57%. The amount of bleeding was small in most cases and kept no relationship with causes.

Neoplasms, chronic bronchitis and bronchiectasis are the most common causes of hemoptisis in our area. Bronchiectasis and tuberculosis have decreased compared with previous series used as reference. In contrast, there has been an increase in the number of neoplasms and chronic bronchitis and a plateau in those attributed to cardiac diseases, pneumonia or lung abscess and cryptogenetic forms. To obtain the origin, bronchoscopy complemented by CT remains essential.