Dilemma on the treatment of haemoptysis: an analysis of 249 patients.

BACKGROUND: Mild haemoptysis can change into massive haemoptysis and unfortunately one cannot predict whether it will change or not. For this reason, we investigated the records of patients who had been admitted due to haemoptysis retrospectively in order to find the trigger mechanisms of haemoptysis and the effects of conservative and aggressive treatment methods.

METHODS: Hospital records of 249 patients with haemoptysis between 1997 and June 2005 were analysed retrospectively. Patients were classified into three groups according to the amount of blood expectorated in 24 hours. Group 1 included cases that had haemoptysis of less than 200 ml/24 h ; group 2 consisted of massive haemoptysis which was defined as expectoration of blood of 200-400 ml/24 h, and group 3 comprised patients who had 400 ml/24 h or more of haemoptysis defined as life-threatening haemoptysis.

RESULTS: There were 169 male and 80 female patients. Mean age was 43.9 (4-78) in male patients and 33.8 (7-82) in female patients. The most frequent cause of haemoptysis was lung cancer in groups 1 and 2, and hydatid disease in group 3. Furthermore, we found that at least one trigger mechanism beyond primary disease caused haemoptysis in all groups.

CONCLUSIONS: Haemoptysis is a life-threatening symptom that can alert patients to see a physician. Mild to moderate haemoptysis may change into massive and life-threatening forms. Unfortunately it is not predictable whether it will change or not. We deduced that a treatment strategy has to be planned according to trigger mechanism in patients with haemoptysis and that surgery is a definitive solution in these patients.