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Long-term prognostic outcomes in patients with haemoptysis

Authors
  • Mondoni, Michele1
  • Carlucci, Paolo1
  • Cipolla, Giuseppe2
  • Pagani, Matteo3
  • Tursi, Francesco4
  • Fois, Alessandro5
  • Pirina, Pietro5
  • Canu, Sara5
  • Gasparini, Stefano6
  • Bonifazi, Martina6
  • Marani, Silvia7
  • Comel, Andrea8
  • Saderi, Laura5
  • De Pascalis, Sabrina1
  • Alfano, Fausta1
  • Centanni, Stefano1
  • Sotgiu, Giovanni5
  • 1 Università degli Studi di Milano, Via A. Di Rudinì n.8, Milan, 20142, Italy , Milan (Italy)
  • 2 UOC Pneumologia, ASST Lodi, Lodi, Italy , Lodi (Italy)
  • 3 UO Pneumologia ed Endoscopia Toracica, Azienda Ospedaliero Universitaria di Parma, Parma, Italy , Parma (Italy)
  • 4 UOS Servizio Pneumologia, Ospedale di Codogno, ASST Lodi, Codogno (Lodi), Italy , Codogno (Lodi) (Italy)
  • 5 University of Sassari, Sassari, Italy , Sassari (Italy)
  • 6 Università Politecnica Delle Marche, Ancona, Italy , Ancona (Italy)
  • 7 UO Medicina Interna, AUSL Modena, Ospedale di Carpi, Carpi (Modena), Italy , Carpi (Modena) (Italy)
  • 8 UO Pneumologia, Ospedale P. Pederzoli, Peschiera del Garda (Verona), Italy , Peschiera del Garda (Verona) (Italy)
Type
Published Article
Journal
Respiratory Research
Publisher
BioMed Central
Publication Date
Aug 04, 2021
Volume
22
Issue
1
Identifiers
DOI: 10.1186/s12931-021-01809-6
Source
Springer Nature
Keywords
Disciplines
  • NCT
License
Green

Abstract

BackgroundHaemoptysis is a challenging symptom that can be associated with potentially life-threatening medical conditions. Follow-up is key in these patients to promptly detect new or misdiagnosed pathologic findings. Few prospective studies have evaluated long-term prognostic outcomes in patients with haemoptysis. Furthermore, the role played by antiplatelet and anticoagulant drugs on mortality and recurrence rates is unclear. The aim of this study was to assess mortality after 18 months of follow-up. Furthermore, the incidence of recurrence and the risk factors for recurrence and death were evaluated (including the role played by anticoagulant and antiplatelet drugs).MethodsObservational, prospective, multicentre, Italian study.Results451/606 (74.4%) recruited patients with haemoptysis completed the 18 months follow-up. 22/604 (3.6%) diagnoses changed from baseline to the end of the follow-up. 83/604 (13.7%) patients died. In 52/83 (62.7%) patients, death was the outcome of the disease which caused haemoptysis at baseline. Only the diagnosis of lung neoplasm was associated with death (OR (95%CI): 38.2 (4.2–347.5); p-value: 0.0001). 166 recurrences were recorded in 103/604 (17%) patients. The diagnosis of bronchiectasis was significantly associated with the occurrence of a recurrence (OR (95% CI): 2.6 (1.5–4.3)); p-value < 0.0001). Anticoagulant, antiaggregant, and anticoagulant plus antiaggregant drugs were not associated with an increased risk of death and recurrence.ConclusionsOur study showed a low mortality rate in patients with haemoptysis followed-up for 18 months. Pulmonary malignancy was the main aetiology and the main predictor of death, whereas bronchiectasis was the most frequent diagnosis associated with recurrence. Antiplatelet and/or anticoagulant therapy did not change the risk of death or recurrence. Follow-up is recommended in patients initially diagnosed with lower airways infections and idiopathic bleeding.Trial registration: NCT02045394

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