A Clinical Study of Patients with Hemosputum or Hemoptysis

Abstract

We reviewed the medical records of 89 patients who underwent fiberoptic bronchoscopy (FB) for unexplained hemosputum or hemoptysis to determine the various causes. Our patient population was predominantly male and elderly with a history of smoking. The most common complication of hemoptysis was hypertension. Chest X-rays showed 35 patients (39.3%) with normal findings. By contrast, there were only 16 patients (18.2%) with normal findings on chest CT. Bleeding was recognized by FB in 36 cases (40.4%), and the likelihood of visualizing active bleeding or its site was higher with early FB versus delayed FB. Idiopathic hemoptysis (40.4%), bronchiectasis (21.3%), and bronchogenic carcinoma (16.9%) accounted for the majority of the causes of hemoptysis. Two of 15 patients with bronchogenic carcinoma had a normal chest X-ray.
We conclude that the following patients with hemosputum or hemoptysis should be examined using FB : (1) all patients with any abnormal findings on chest X-ray or chest CT, (2) patients over 40 years old with significant smoking history even without abnormal findings on chest X-ray, (3) patients with hemosputum or hemoptysis lasting more than one week.