Risk factors and recurrence patterns in 203 patients with hemoptysis

Management of hemoptysis requires prompt diagnosis and patient stabilization especially in massive hemoptysis as a potentially life-threatening condition. This retrospective study was designed to determine the etiologic distribution of hemoptysis, the role of the fiberoptic bronchoscopy (FOB) as a diagnostic tool, and to clarify potential risk factors for massive hemoptysis and recurrences. A total of 203 patients (181 male, 22 female) with hemoptysis admitted to our hospital were evaluated retrospectively. Tuberculosis was the leading cause of hemoptysis (n = 89; 43.8%) followed by lung cancer (21.7%) and chronic bronchitis (n = 11; 5.5%). FOB plays an essential role for localization of bleeding and diagnosis, although no bronchoscopic abnormality was found in our 31 patients (15.3%). Twenty-nine of the patients (14.3%) had recurrent hemoptysis and hemoptysis lasting longer than five days was found as a risk factor for recurrences (p = 0.02). Having lung cancer was an independent negative risk factor for recurrent hemoptysis using multivariate analysis (n = 44; p = 0.034). Twenty two of the patients (10.8%) had severe hemoptysis and managed medically. In our study, tuberculosis, lung cancer and heavy cigarette smoking were revealed as independent predictors of massive hemoptysis (p = 0.016, 0.001, 0.041 respectively). Hemoptysis is a common respiratory symptom that always requires investigation by using FOB and radiography in order to determine exact site of bleeding and etiology. Hemoptysis continuing more than five days and lung cancer diagnosis may indicate recurrent bleeding and need more attention.