Respiratory failure & ventilation
Severe hemoptysis: etiologies, management, and outcomes from a single-center experience over the last decade
Authors' conclusion
Over the past decade, lung cancer became the leading cause of SH, with pneumonia increasingly contributing to pulmonary arterial involvement, reinforcing the need for multi-detector computed tomography angiography (MDCTA) screening.
Study context
- Population
- Patients admitted to the intensive care unit (ICU) of a referral center for severe hemoptysis (SH), 2009–201975% males
- Participants
- 945 patients
- Exposure
- SH patients 2009–2019 vs historical cohort
- 2009–2019n = 945
- Outcome
- Clinical characteristics, etiologies, management and outcomes of SH
Methodological detailssingle-centre, historical cohort comparison
- Single-centre
- Historical cohort comparison
Main finding
As reported in the abstract
- Respiratory comorbidities
- 67%
- Invasive mechanical ventilation within 24 h of ICU admission
- 13%
- Vascular interventional radiology (VIR) first attempted
- 81%
- Bleeding control with VIR
- more than 90%
- Emergent surgical lung resection (within 72 h), all after VIR
- 2%
Observational data: associations, not effects.
Further findings
Pneumonia-related hemoptysis, vs historical cohort (1995-2009)
- Pneumonia-related hemoptysis increased vs the historical cohort
- 11% vs. 5%; P < 0.001
- Cochran-Armitage test
Pulmonary arterial involvement, vs historical cohort (1995-2009)
- Pulmonary arterial involvement increased vs the historical cohort
- 12% vs. 5%; P < 0.001
- Pulmonary arterial involvement associated with pneumonia
- 23%
- Pulmonary arterial involvement associated with cancer or aspergillosis (each)
- 20%
In-hospital mortality, vs historical cohort (1995-2009)
- In-hospital mortality rate increased slightly vs the historical cohort
- 8.7% vs. 6.5%; P = 0.08
Vascular interventional radiology (VIR)
- VIR first attempted
- 81%
- Bleeding control with VIR
- more than 90%
Invasive mechanical ventilation within 24 h of ICU admission
- Invasive mechanical ventilation required
- 13%
Emergent surgical lung resection (within 72 h)
- Emergent surgical lung resection, all after VIR
- 2%
Safety
- Major adverse events
- 4.4%
Original publication
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