Haemoptysis: Aetiology and Outcome in a Third World Tertiary Hospital

Study objectives: To determine the etiology and outcome of patients admitted with haemoptysis.

Design: A prospective cohort study.

Setting and Patients: A tertiary referral hospital with cardiothorasic and angiographic facilities. Patients with haemoptysis requiring admission under the Medical Department from January 1st 1999 to December 31st 1999 were included in the study.

Results: Post tubercular bronchiectasis(32%), active tuberculosis(20%), primary carcinoma of lung(12%), bacterial pneumonia(10%) and bronchiectasis(non tubercular) 8% accounted for most causes of haemoptysis. On the whole, infectious diseases(TB and non TB) were the major causes. HRCT was very sensitive in the diagnosis, when employed. The mortality was 6.7% irrespective of the amount of bleeding. 2.7% remained undiagnosed.

Conclusion: Haemoptysis remains to be a common cause of admission in our hospital. The most frequent causes are related to infections, particularly tuberculosis(active or healed). The mortality is low if supportive care can be provided. HRCT is of great value in the diagnostic evaluation. Bronchial artery embolization can be life saving in persistent massive haemoptysis.