Risk Factors for a Second Episode of Hemoptysis

Abstract

Background: Of lung diseases, Hemoptysis is an alarming symptom. It is difficult for clinicians to choose how to deal with patients who had a single episode of hemoptysis, especially if the cause is unknown. Using multivariate analysis, investigations were done to see whether any factor in the initial episode could be a predictor of second episode. Aim: In
this study, by using multivariate analysis, to check whether any clinical factor present during initial episode of hemoptysis are useful predictors of second episode of hemoptysis. Materials and Methods: 100 Patients with initial episode of hemoptysis, their medical records were reviewed. Patients who had undergone both chest CT and bronchoscopic examinations were selected in the study. Results: 100 patients were selected. From bronchial lavage fluid, active and inactive fluid were isolated in 17 (17%) cases. On further examination, diagnosis was not established in 27 (27%) cases. The predictors of hemoptysis were bacteria from bronchial lavage which has shown a 62 patients were negative for bacteria and 7 patients were positive for bacteria out of a total of 69 patients in initial episode and 21 patients showed negative to bacteria and 10 patients showed positive to bacteria out of a total of 31 patients in reccurent episode. All the demographic details of initial episode and recurrent cases are insignificant on comparision. Most of the cases of recurrent cases are positive for bacteria from bronchial lavage and ethiology is known. Regardless of the volume of the initial episode, the failure to determine the etiology of an initial episode of hemoptysis was associated with an increased risk of a massive second episode (P = 0.040).Conclusion: There is an increased possibility of a second episode of hemoptysis in patients with bacterial colonization of the respiratory tract or an initial episode of hemoptysis of unknown etiology.