Pulmonology Xagena

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Haemoptysis is a life-threatening symptom unveiling potentially life-threatening underlying conditions

Haemoptysis is a serious symptom with various aetiologies. The aim of a study was to define the aetiologies, outcomes and associations with lung cancer in the entire population of a high-income country.

This retrospective multicentre study was based on the French nationwide hospital medical information database collected over 5 years ( 2008–2012 ).
Researchers analysed haemoptysis incidence, aetiologies, geographical and seasonal distribution and mortality. They studied recurrence, association with lung cancer and mortality in a 3-year follow-up analysis.

Each year, approximately 15 000 adult patients ( mean age 62 years, male/female ratio 2/1 ) were admitted for haemoptysis or had haemoptysis as a complication of their hospital stay, representing 0.2% of all hospitalised patients.

Haemoptysis was cryptogenic in 50% of cases.

The main aetiologies were respiratory infections ( 22% ), lung cancer ( 17.4% ), bronchiectasis ( 6.8% ), pulmonary oedema ( 4.2% ), anticoagulants ( 3.5% ), tuberculosis ( 2.7% ), pulmonary embolism ( 2.6% ) and aspergillosis ( 1.1% ).

Among incident cases, the 3-year recurrence rate was 16.3%.

Of the initial cryptogenic haemoptysis patients, 4% were diagnosed with lung cancer within 3 years.

Mortality rates during the first stay and at 1 and 3 years were 9.2%, 21.6% and 27%, respectively.

This is the first epidemiological study analysing haemoptysis and its outcomes in an entire population. ( Xagena )

Abdulmalak C et al, Eur Respir J 2015;46:503-511