Early Prediction of In-Hospital Mortality of Patients with Hemoptysis: An Approach to Defining Severe Hemoptysis

Fartoukh, Muriel; Khoshnood, Babak; Parrot, Antoine; Khalil, Antoine; Carette, Marie-France; Stoclin, Annabelle; Mayaud, C; Cadranel, Jacques; Ancel, Pierre‐Yves

doi:10.1159/000331501

Cited by 73 publications

(74 citation statements)

References 68 publications

(42 reference statements)

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“…Our results concerning in-hospital mortality (7% when deaths from lung cancer were excluded) during the first episode of haemoptysis did not differ from those in other studies [1,5,21]. The mortality rates in the subgroup of haemoptysis of unknown origin were similar, suggesting that the lack of a described aetiology at the initial evaluation was not a distinct risk factor for increased mortality in our study.…”

Section: Discussionsupporting

confidence: 53%

Haemoptysis in adults: a 5-year study using the French nationwide hospital administrative database

et al. 2015

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Haemoptysis is a serious symptom with various aetiologies. Our aim 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)(2009)(2010)(2011)(2012). We analysed haemoptysis incidence, aetiologies, geographical and seasonal distribution and mortality. We studied recurrence, association with lung cancer and mortality in a 3-year follow-up analysis.Each year, ∼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. Haemoptysis is a life-threatening symptom unveiling potentially life-threatening underlying conditions. @ERSpublications Haemoptysis is ominous: there is often no clear aetiology and 4% of patients develop lung cancer during follow-up

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Section: Discussionsupporting

confidence: 53%

Haemoptysis in adults: a 5-year study using the French nationwide hospital administrative database

et al. 2015

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“…We showed that the frequency of recurrence was relatively low, since 84% of patients with initial haemoptysis had no recurrence within the 3 years of follow-up. Moreover, even though it was explored in small prospective studies, we found substantial mortality rates during the initial stay as expected [5] but, more interestingly, during the follow-up as well. Indeed, the 3-year in-hospital mortality rate, excluding lung cancers, was high at 20%.…”

Section: From the Authorssupporting

confidence: 70%

Haemoptysis: a frequent diagnostic challenge

Bonniaud¹,

Georges²,

Abdulmalak³

et al. 2015

Eur Respir J

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“…El riesgo de fallecer de un paciente hospitalizado por micosis y cáncer encontrado en nuestro estudio fue 0,22 y 0,25, respectivamente, Contrariamente, el riesgo de fallecer de bronquiectasia y tuberculosis activa fue 0,14 y 0,11, respectivamente. Muriet (7) en su estudio realizado en el hospital de Paris, Francia, encontró el riesgo de fallecer por micosis y cáncer de 0,08 y 0,29, respectivamente. Este riesgo bajo de mortalidad intrahospitalaria para micosis se explicaría por la baja incidencia de micosis en Francia y el bajo número de pacientes incluidos en su estudio con este diagnóstico (48/715).…”

Section: Discussionunclassified

“…Para ello sugieren que dentro de la evaluación del pronóstico del paciente con hemoptisis no solo se considere el volumen del sangrado sino que, además, se deberá tomar en cuenta otras consideraciones relacionadas fundamentalmente a la reserva respiratoria funcional del paciente (7) .…”

Section: Introductionunclassified

Predictores de mortalidad en pacientes con hemoptisis en un servicio de emergencia

Camarena¹,

Castillo²,

Cozar³

et al. 2016

An Fac med

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Predictores de mortalidad en pacientes con hemoptisis en un servicio de emergenciaPredictors of mortality in patients with hemoptysis in the emergency room ResumenIntroducción. La hemoptisis es una de las manifestaciones más alarmantes de las enfermedades broncopulmonares y representa el 7% de los ingresos hospitalarios a los servicios de medicina Interna. La hemoptisis severa está relacionada a cifras altas de mortalidad alrededor del 40%. Existen múltiples factores que cuando coexisten con hemoptisis alteran su evolución y pronóstico. No solo la severidad de la hemoptisis determina el riesgo de muerte, sino la presencia de comorbilidades, especialmente pulmonares que afectan la reserva funcional del paciente. Objetivos. Determinar la mortalidad y los factores que incrementan la mortalidad en pacientes con hemoptisis que son admitidos por un servicio de emergencia. Diseño. Estudio analítico. Institución. Servicio de emergencia, Hospital Nacional Dos de Mayo, Lima, Perú. Participantes. Pacientes con diagnóstico de hemoptisis. Métodos. Se revisaron 108 historias clínicas de pacientes que fueron hospitalizados por emergencia con diagnóstico de hemoptisis en un lapso de 2 años. Se recolectaron las variables edad, sexo, procedencia, presencia de comorbilidades, reserva funcional respiratoria cualitativa, entre otros. Los resultados se expresaron en distribución de frecuencias absolutas y relativas, medias (+1DE); los factores relacionados a incremento de mortalidad se les determinó mediante el estimado del riesgo relativo (RR). Para la comparación de proporciones se utilizó la prueba chi 2 . Para determinar las variables asociadas a mortalidad se usó el modelo de regresión logística múltiple. Principales medidas de resultados. Factores asociados a incremento de mortalidad. Resultados. Los factores asociados a incremento de mortalidad fueron la presencia de caverna mayor de 1 cm de diámetro, de localización hiliar, y el antecedente de readmisiones por hemoptisis. Así mismo, la presencia de fibrosis pulmonar que comprometía más de 50% del parénquima pulmonar bilateral fue importante predictor de mortalidad. Conclusiones. La reserva funcional pulmonar fue el determinante principal relacionado a mortalidad en pacientes con hemoptisis que fueron hospitalizados por emergencia. Palabras clave. Hemoptisis; Mortalidad; Pronóstico. Abstract Introduction. Hemoptysis is one of the most alarming manifestations of bronchopulmonary diseases and represents 7% of hospital admissions to Internal Medicine services. Severe hemoptysis is related to high mortality in about 40%. Multiple factors that coexist with hemoptysis alter its evolution and prognosis. Not only the severity of the hemoptysis determines the risk of death, but also the presence of comorbid conditions, especially pulmonary pathologies affecting the patient's functional reserve. Objectives. To determine the mortality and factors that increase mortality in patients with hemoptysis admitted by the Emergency Room. Design. Analytical study. Setting. Hospital Nacional Dos d...

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Early Prediction of In-Hospital Mortality of Patients with Hemoptysis: An Approach to Defining Severe Hemoptysis

Cited by 73 publications

References 68 publications

Haemoptysis in adults: a 5-year study using the French nationwide hospital administrative database

Haemoptysis in adults: a 5-year study using the French nationwide hospital administrative database

Haemoptysis: a frequent diagnostic challenge

Predictores de mortalidad en pacientes con hemoptisis en un servicio de emergencia

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