Predictive factors of hemoptysis recurrence after hospital discharge

Hemoptysis is a potentially life-threatening symptom that requires prompt evaluation and management. Its recurrence can be as distressing as the initial episode and represents a significant clinical concern.

This study aimed to identify predictors of hemoptysis recurrence outside the hospital setting.

We conducted a retrospective, longitudinal, descriptive, and analytical study including all patients hospitalized for hemoptysis in the Pneumology Department of Charles Nicolle Hospital, Tunis, between January 2015 and June 2022. The follow-up period extended from the first hospitalization to the last medical consultation, with a minimum duration of one year. Patients who experienced recurrence during follow-up were analyzed to identify clinical, etiological, and therapeutic factors associated with hemoptysis recurrence.

A total of 200 patients were included, with a mean age of 52.5 ± 15.8 years (range: 18-90), and a marked male predominance (83.5%). Active smoking was reported in 83.5% of patients. Drug use was noted in 13% of cases, and 15% had high-risk behaviors. Comorbidities were present in 52% of patients, predominantly cardiovascular diseases. Five patients (2.5%) were receiving vitamin K antagonists, and eight (4%) were on antiplatelet therapy. Multivariate logistic regression analysis identified cardiovascular comorbidities (OR = 2.2), bronchiectasis (OR = 9.8), and antiplatelet therapy (OR = 3) as independent predictors of hemoptysis recurrence. Additionally, markers of initial episode severity, including acute anemia requiring blood transfusion (OR = 2.5) and the need for octreotide (OR = 8.2), were significantly associated with an increased risk of out-of-hospital recurrence.

These findings underscore the importance of risk stratification, close follow-up, and individualized management in patients at high risk of hemoptysis recurrence. Early identification of predictive factors may help optimize preventive strategies and improve clinical outcomes.