Factors associated with poor in-hospital evolution of hemoptysis

Abstract

<bold>Introduction:</bold> Hemoptysis is a frequent cause of hospitalization in pneumology and represents a therapeutic emergency with a potentially severe in-hospital course. The aim of this study was to identify the factors associated with a poor in-hospital evolution of hemoptysis. <bold>Methods:</bold> We conducted a retrospective study including patients hospitalized for hemoptysis at the Pneumology Department of Charles Nicolle Hospital in Tunis between 2015 and 2024. Poor outcome was defined by a moderate to major or cataclysmic hemoptysis, poor hemodynamic and/or respiratory tolerance, deglobulization or death. <bold>Results:</bold> The study included 271 patients with a mean age of 53 ± 15 years and a sex ratio of 5. 48.2% of patients had an unfavorable intrahospital evolution of hemoptysis. Among these, 82.4% had moderate to major hemoptysis, 3% had unstable hemodynamic and respiratory state. Deglobulization was present in 31.7% with a mean hemoglobin drop of 1.46g/dl ± 1.05 g/dl. Death secondary to hemoptysis occurred in 6% of patients. Factors significantly associated with a poor in-hospital outcome were drug addiction (p <0.001), risky behavior (p<0.001), history of pulmonary tuberculosis (p =0.01), recurrent hemoptysis (p =0.01), etiological diagnoses of pulmonary neoplasia, current lung tuberculosis and bronchiectasis (p =0.02). <bold>Conclusion:</bold> Factors associated with a poor in-hospital evolution included drug addiction, risky behaviors, history of pulmonary tuberculosis, recurrence of hemoptysis, and specific etiologies (pulmonary neoplasia, pulmonary tuberculosis and bronchiectasis). These findings highlight the importance of early identification to optimize patient management and prognosis.