Long-term prognostic outcomes in patients with haemoptysis

Respiratory Research

Laura Saderi¹  Giovanni Sotgiu¹  Pietro Pirina²  Alessandro Fois²  Sara Canu²  Stefano Gasparini³  Martina Bonifazi³  Michele Mondoni⁴  Fausta Alfano⁴  Paolo Carlucci⁴  Sabrina De Pascalis⁴  Stefano Centanni⁴  Silvia Marani⁵  Matteo Pagani⁶  Andrea Comel⁷  Giuseppe Cipolla⁸  Francesco Tursi⁹ 

[1] Clinical Epidemiology and Medical Statistics Unit, Dept of Medical, Surgical and Experimental Sciences, University of Sassari;Lung Disease Unit, Dept of Clinical and Experimental Medicine, University of Sassari;Pulmonary Disease Unit, Department of Internal Medicine, Azienda Ospedali Riuniti, Department of Biomedical Sciences and Public Health, Università Politecnica Delle Marche;Respiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Department of Health Sciences, Università degli Studi di Milano;UO Medicina Interna, AUSL Modena, Ospedale di Carpi;UO Pneumologia ed Endoscopia Toracica, Azienda Ospedaliero Universitaria di Parma;UO Pneumologia;UOC Pneumologia, ASST Lodi;UOS Servizio Pneumologia, Ospedale di Codogno, ASST Lodi;

关键词: Haemoptysis;    Recurrence;    Lung cancer;    Bronchoscopy;    Anticoagulant;    Antiplatelet;   

DOI  :  10.1186/s12931-021-01809-6

来源: DOAJ

【 摘 要 】

Abstract Background Haemoptysis 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). Methods Observational, prospective, multicentre, Italian study. Results 451/606 (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. Conclusions Our 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

【 授权许可】

Unknown