Abstract
Hemoptysis is a serious symptom with various etiologies. Our aim was to define etiologies, outcomes and associations with lung cancer in an entire population of a high-income country.
Methods: This retrospective multicenter study was based on the French nationwide hospital medical information database collected over five years (2008-2012).We analyzed hemoptysis incidence, etiologies, geographical and seasonal distribution and mortality. We studied recurrence, association with lung cancer and mortality in a 3 year-follow up analysis.
Results: Every year, about 15,000 adult patients (mean age 62, M/F-ratio 2/1) were admitted for hemoptysis or had hemoptysis as a complication of their hospital stay, representing 0.2% of all hospitalized patients. The mean duration of the initial hospital stay for hemoptysis was 8.0 +/- 12.5 days, and during this stay 9% of these patients were admitted to an ICU (from 7% to 10%). Hemoptysis was cryptogenic in 50% of cases. The main etiologies were respiratory infections (22%), lung cancer (17.4%), bronchiectasis (6.8%), pulmonary edema (4.2%), anticoagulants (3.5%), tuberculosis (2.7%), pulmonary embolism (2.6%) and aspergillosis (1.1%). Among incident cases, the three-year recurrence rate was 16.3%. Among patients with initial cryptogenic hemoptysis, 4% were diagnosed with lung cancer within three years. Mortality during the first stay and at one and three years was 9.2%, 21.6% and 27%, respectively.
Conclusion: This is the first epidemiological study on an entire population analyzing hemoptysis and its outcomes. Hemoptysis is a life-threatening symptom unveiling potentially life-threatening underlying conditions.
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