Risk Factors for Hemoptysis in Pulmonary Tuberculosis Patients from Southern China: A Retrospective Study

Shouyong Tan,Tianyu Zhang,Moses M Njire,Yuanyuan Cao,Yanqiong Li,Danxiong Sun,Tiantuo Zhang,Changwei Wang

doi:10.4236/jtr.2014.24022

Abstract

Clinical characteristics of tuberculosis (TB) patients from southern China with pulmonary tuberculosis hemoptysis (PTH) were analyzed retrospectively in order to improve the diagnosis of TB, reduce mortality and prevent the transmission of TB. A total of 1227 cases of pulmonary TB patients hospitalized in the Third Affiliated Hospital of Sun Yat-sen University and Guangzhou Chest Hospital from January to December of 2011 were analyzed retrospectively. 1) The male/female ratio of the 1227 tuberculosis cases was 2.15:1. There were 403 cases (32.8%) of PTH with a male/ female ratio of 3.03:1. 2) The ratio of patients with PTH to those with TB was designated as Rh. The Rh in the male group (36.2%, 303 cases) was higher than that in the female group (25.6%, 100 cases, risk ratio (RR) = 1.41, P ≤ 0.001). 3) The Rh in the elderly group (≥60 years old, 20.3%, 56 cases) was lower than that in the younger patients group (20 - 39 years old, 45.4%, 189 cases, RR = 2.51, P ≤ 0.001). 4) The Rh in initial treatment group (29.6%, 296 cases) was lower than that in the retreatment group (46.9%, 107 cases, RR = 1.58, P ≤ 0.001). 5) The Rh in sputum-positive TB patients (44.5%, 297 cases) was significantly higher than that in the smear-negative TB patients (18.9%, 106 cases, RR = 2.35, P ≤ 0.001). 6) The Rh of patients with lung lesions range 0.05). 7) The Rh of patients with cavities (51.8%, 309 cases) was higher than that of patients without cavities (14.9%, 94 cases, RR = 3.48, P ≤ 0.001). Male, young, retreated, sputum-positive TB patients and those with cavitary TB were more predisposed to PTH in southern China. TB patients with such characteristics should be sensitized and accorded good care.

Highlights

Hemoptysis is the expectoration or spitting of blood originating from any part of the respiratory tract, usually from hemorrhage in the lung parenchyma and the bronchial arteries [1]
We intended to assess risk factors associated with hemoptysis in patients with tuberculosis (TB) or post-TB sequelae in a country where TB burden is relatively high, because active TB has been shown to be a major etiology of hemoptysis
Besides being a feature of active TB, hemoptysis can be a manifestation of complications such as cavitation, fibrosis, bronchiectasis, and mycetoma

Summary

Introduction

Hemoptysis is the expectoration or spitting of blood originating from any part of the respiratory tract, usually from hemorrhage in the lung parenchyma (pulmonary alveoli) and the bronchial arteries [1]. It may be a symptom of several diseases, more or less severe, but its appearance induces concern to the patient and requires a full diagnostic investigation. Rupture of Rasmussen’s aneurysm can occur with active disease or as a late finding It occurs when there is rupture of ectatic portions of the pulmonary arteries traversing thickwalled cavities [3]

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Conclusion