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Management of hemoptysis in a Third World city hospital: a retrospective study
K W van Kralingen1, A C van Kralingen-Heijboer, M Zimmerman
1Department of Pulmonology, Free University Hospital, Amsterdam, The Netherlands.
Background:
Massive hemoptysis (defined as blood loss greater than 600 ml/24h) is said to have a fatal outcome in up to 85% of patients when managed only medically.
Methods:
A retrospective patient chart study was undertaken to analyse underlying pathology, management and outcome of hemoptysis patients in a hospital with no thoracic surgical, bronchoscopic or embolisation facilities.
Results:
63 patients were admitted for hemoptysis during a 2.5 year study period. Tuberculosis and sequelae of previous tuberculosis accounted for 65% of the cases. The patients with expectoration of more than 600 ml/24h had a shorter duration of hemoptysis (P = 0.033) and more often a history of tuberculosis (P = 0.023). The mortality rate was 6% (4/63 patients). Recurrent bleeding was not frequent (11%) and never severe enough for admission.
Conclusions:
Hemoptysis in a Third World city hospital is mainly caused by infectious disease. Under the above-mentioned circumstances, in view of a low mortality and recurrence rate, conservative treatment of hemoptysis in in-patients seems justified.