CLINICAL PROFILE OF PATIENTS WITH HEMOPTYSIS AT A TERTIARY CARE CENTRE IN CENTRAL INDIA: A RETROSPECTIVE STUDY OF 47 CASES

Abstract

Background: Hemoptysis, the expectoration of blood from the respiratory tract, is a symptom with a wide spectrum of underlying causes, ranging from benign to life-threatening conditions. Understanding the clinical characteristics of these patients is vital for prompt diagnosis and effective management, particularly in tertiary care centers where complex cases are prevalent. Objective: To analyze the clinical presentations, diagnostic findings, and outcomes of patients presenting with hemoptysis at a tertiary care center. Materials and Methods: This retrospective observational study was conducted from January 2022 to December 2023 in the respiratory medicine department of a tertiary care center. A total of 47 patients aged over 18 years with confirmed hemoptysis were included. Data were collected from medical records, covering demographic details, clinical presentation, laboratory and radiological findings, bronchoscopy results, treatment methods, and outcomes. Descriptive statistics were employed to summarize the data. Results: The study cohort consisted of 47 patients with a mean age of 52 ± 14 years 60% were male. Acute hemoptysis was observed in 64% of cases. Hemoptysis severity was categorized as mild in 43%, moderate in 32%, and massive in 25% of patients. Common associated symptoms included cough (85%), fever (60%), weight loss (32%), chest pain (26%), and dyspnea (53%). Smoking history was present in 60% of patients. The predominant underlying conditions were COPD (30%), bronchiectasis (21%), tuberculosis (15%), lung cancer (11%), cardiovascular diseases (11%), and other conditions (13%). Abnormalities were detected in 74% of chest X-rays and 89% of CT scans, which included findings such as consolidation, cavitation, masses, and bronchiectasis. Bronchoscopy was performed in 51% of patients, with a diagnostic yield of 64%, revealing endobronchial lesions, bleeding sites, and inflammation. Management and Outcomes: Medical management included antibiotics (43%), bronchodilators (32%), steroids (19%), antitubercular therapy (15%), and anticoagulant reversal (6%). Interventional procedures, such as bronchial artery embolization, were performed in 11% of patients, and surgical resection was referred for 4% of patients. Hemoptysis resolution was achieved in 81% of cases, with a recurrence rate of 11% and a mortality rate of 6%. Discussion: COPD and bronchiectasis were the leading causes of hemoptysis, highlighting the prevalence of chronic respiratory diseases in the studied population. The significant diagnostic yield of CT chest and bronchoscopy underscores their importance in evaluating hemoptysis. Effective medical management was achieved in most cases, while interventional procedures were critical for controlling massive hemoptysis. The study identifies challenges in managing massive and recurrent hemoptysis and suggests the need for standardized management protocols. Conclusion: Hemoptysis in a tertiary care setting is frequently associated with chronic respiratory diseases such as COPD and bronchiectasis. Comprehensive diagnostic approaches, particularly CT chest and bronchoscopy, are crucial for effective management. Early identification and treatment of the underlying causes are essential for improving patient outcomes. The findings underscore the need for developing clinical guidelines and conducting further research on innovative diagnostic and therapeutic strategies.