Etiologies, Investigations and Outcomes of Patients Presenting With Hemoptysis

Etiologies, Investigations and Outcomes of Patients Presenting With Hemoptysis in a North-American Tertiary Center at the Beginning of the 21st Century

The study consist of a retrospective analysis of the etiologies, investigations and outcomes of patients presenting between 2005 to 2010 with hemoptysis in a North-American Tertiary center.

Study Overview

• Status: Unknown
• Conditions: Pathologic Processes; Respiratory Tract Infections; Respiratory Tract Diseases; Pneumonia; Hemorrhage; Bronchiectasis; Mycobacterium Infections; Signs and Symptoms, Respiratory; Lung Cancer; Tuberculosis; Lung Disease; Bronchitis; Pulmonary Embolism; Arteriovenous Fistula; Signs and Symptoms; Pulmonary Hemorrhage; Haemoptysis; Hemoptysis; Bronchial Disease; Mycosis

Detailed Description

RATIONALE:

Hemoptysis, mild or massive, is worrisome for both patients and physicians. The management is different depending on the causes, which are not well defined for the North American population. Despite the fact that this symptom is commonly reported in clinic, there are only a few studies published on this subject in the North-American population. Tuberculosis was a frequent cause of hemoptysis described in populations overseas, which seems less prevalent in the investigators center.

Also, there are no known official guidelines regarding the investigation and management of hemoptysis. The investigators hypothesized that the use of modern technology in a North American population may result in different findings and provide a more accurate diagnostic approach.

Therefore, the study compares the different etiologies of hemoptysis and investigation modalities used in patients presenting in a North-American tertiary center.

METHOD:

The investigators did a retrospective analysis of medical chart from patients with hemoptysis who visited the investigators center between 2005 and 2010. Each visit has been reviewed individually to describe the characteristics of patients, etiologies of hemoptysis and investigation modalities used. All-cause mortality at 2 years was also recorded.

Descriptive statistical analyses will conducted on the data available.

• Study Type: Observational
• Enrollment (Anticipated): 1000

Contacts and Locations

• Study Contact: Name: Brian Grondin-Beaudoin, MD; Phone Number: 18193461110; Email: brian.grondin.beaudoin@usherbrooke.ca
• Study Contact Backup: Name: Matthieu Poirier, MD; Phone Number: 18193461110; Email: matthieu.benoit.jose.poirier@usherbrooke.ca

Study Locations

• Canada
  • Quebec
    • Sherbrooke, Quebec, Canada, J1G2E8
      • Recruiting
      • Centre Hospitalier Universitaire de Sherbrooke
      • Contact: Brian Grondin-Beaudoin, MD; Phone Number: 18193461110; Email: brian.grondin.beaudoin@usherbrooke.ca
      • Contact: Matthieu Poirier, MD; Phone Number: 18193461110; Email: matthieu.benoit.jose.poirier@usherbrooke.ca
      • Sub-Investigator: Amelie Blanchard, MD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

Any patient presenting with hemoptysis at the Centre Hospitalier Universitaire de Sherbrooke on an outpatient basis, emergency department or hospitalized at hopital Fleurimont or Hotel-Dieu of Sherbrooke.

Description

Inclusion Criteria:

Any patient over the age of 18 presenting with:

• A diagnosis of hemoptysis on an outpatient basis.
• A diagnosis of hemoptysis during consultation in the emergency department.
• A diagnosis of hemoptysis on the admission sheet.
• A diagnosis of hemoptysis when hospitalized.
• A complication of hemoptysis
• Hemoptysis on the report of the bronchoscopy, chest computed tomography, pulmonary angiography, ventilation-perfusion single-photon emission computed tomography or blood transfusion.

Exclusion Criteria:

• Patients under 18 years of age.
• Patient who refused investigation for hemoptysis.
• Incomplete medical chart

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
Patients presenting with hemoptysis; Patients over 18 years of age presenting with hemoptysis at the Centre Hospitalier Universitaire de Sherbrooke (CHUS) between the periods of 2005 to 2010.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Etiologies of hemoptysis	Defining the prevalence of pulmonary diseases by measuring the percentage of patients presenting with hemoptysis caused by lung cancer, bronchiectasis, pulmonary embolism, arteriovenous fistula, pneumonia, bronchitis, tuberculosis, mycosis, heart failure, pseudohemoptysis, cryptogenic and other causes.	5 years

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Sensitivity of chest X-ray, chest CT-scan and CT-angiography, bronchoscopy, ventilation-perfusion with single-photon emission computed tomography and pulmonary angiography.	Determining the sensitivity in obtaining the etiology of the hemoptysis episode of each diagnostic modality that follows : chest X-ray, chest CT-scan and CT-angiography, bronchoscopy, ventilation-perfusion with single-photon emission computed tomography and pulmonary angiography in the diagnosis of different etiologies of hemoptysis.	5 years
All-cause mortality at 2 years	All-cause mortality at 2 years after the diagnosis of hemoptysis.	2 years
Smoking status	Determining the percentage of patients who : never smoked, is an active smoker, former smoker or unknown status.	Day 1
Age	Determining the average age of the enrolled patients.	Day 1
Gender	Determining the percentage of each gender of the enrolled patients.	Day 1
International Normalized Ratio	Determining the median of the international normalized ratio (INR).	Day 1
Partial Thromboplastin Time	Determining the median of the partial thromboplastin time (PTT).	Day 1
Platelet count	Determining the average of the platelet count measured per microliter of blood.	Day 1

Collaborators and Investigators

• Sponsor: Université de Sherbrooke
• Investigators: Principal Investigator: Brian Grodin-Beaudoin, MD, Université de Sherbrooke

Publications and helpful links

General Publications

• Hirshberg B, Biran I, Glazer M, Kramer MR. Hemoptysis: etiology, evaluation, and outcome in a tertiary referral hospital. Chest. 1997 Aug;112(2):440-4. doi: 10.1378/chest.112.2.440.
• Jeudy J, Khan AR, Mohammed TL, Amorosa JK, Brown K, Dyer DS, Gurney JW, MacMahon H, Saleh AG, Vydareny KH; Expert Panel on Thoracic Imaging. ACR Appropriateness Criteria hemoptysis. J Thorac Imaging. 2010 Aug;25(3):W67-9. doi: 10.1097/RTI.0b013e3181e35b0c.
• Alaoui AY, Bartal M, el Boutahiri A, Bouayad Z, Bahlaoui A, el Meziane A, Naciri A. [Clinical characteristics and etiology in hemoptysis in a pneumology service. 291 cases]. Rev Mal Respir. 1992;9(3):295-300. French.
• Reechaipichitkul W, Latong S. Etiology and treatment outcomes of massive hemoptysis. Southeast Asian J Trop Med Public Health. 2005 Mar;36(2):474-80.
• Sanai Raggad S, Abid H, Ghedira H, Tritar F, Hamzaoui A. [Current etiologies of hemoptysis in the elderly: comparative study of 360 cases]. Tunis Med. 2010 Nov;88(11):809-13. French.
• Unsal E, Koksal D, Cimen F, Taci Hoca N, Sipit T. Analysis of patients with hemoptysis in a reference hospital for chest diseases. Tuberk Toraks. 2006;54(1):34-42.
• Prasad R, Garg R, Singhal S, Srivastava P. Lessons from patients with hemoptysis attending a chest clinic in India. Ann Thorac Med. 2009 Jan;4(1):10-2. doi: 10.4103/1817-1737.43062.
• Soares Pires F, Teixeira N, Coelho F, Damas C. Hemoptysis--etiology, evaluation and treatment in a university hospital. Rev Port Pneumol. 2011 Jan-Feb;17(1):7-14. doi: 10.1016/s2173-5115(11)70004-5. English, Portuguese.
• Pedrol E, Fernandez-Sola J, Ferrer M, Barcelo J, Bosch X, Sande L, Camp J, Borras A, Urbano-Marquez A. [Hemoptysis: a prospective study of 108 cases in an emergency service]. Rev Clin Esp. 1991 May;188(9):450-4. Spanish.
• Tsoumakidou M, Chrysofakis G, Tsiligianni I, Maltezakis G, Siafakas NM, Tzanakis N. A prospective analysis of 184 hemoptysis cases: diagnostic impact of chest X-ray, computed tomography, bronchoscopy. Respiration. 2006;73(6):808-14. doi: 10.1159/000091189. Epub 2006 Jan 27.
• Wong CM, Lim KH, Liam CK. The causes of haemoptysis in malaysian patients aged over 60 and the diagnostic yield of different investigations. Respirology. 2003 Mar;8(1):65-8. doi: 10.1046/j.1440-1843.2003.00437.x.
• Haro Estarriol M, Vizcaya Sanchez M, Jimenez Lopez J, Tornero Molina A. [Etiology of hemoptysis: Prospective analysis of 752 cases]. Rev Clin Esp. 2001 Dec;201(12):696-700. doi: 10.1016/s0014-2565(01)70953-8. Spanish.

Study record dates

Study Major Dates

• Study Start: October 1, 2012
• Primary Completion (Anticipated): June 1, 2017
• Study Completion (Anticipated): June 1, 2017

Study Registration Dates

• First Submitted: September 15, 2016
• First Submitted That Met QC Criteria: September 22, 2016
• First Posted (Estimate): September 23, 2016

Study Record Updates

• Last Update Posted (Estimate): September 23, 2016
• Last Update Submitted That Met QC Criteria: September 22, 2016
• Last Verified: September 1, 2016

More Information

Terms related to this study

• Keywords: Haemoptysis; Hemoptysis; Pulmonary hemorrhage; Airway bleeding
• Additional Relevant MeSH Terms: Cardiovascular Diseases; Vascular Diseases; Disease Attributes; Congenital Abnormalities; Embolism and Thrombosis; Bacterial Infections; Bacterial Infections and Mycoses; Gram-Positive Bacterial Infections; Actinomycetales Infections; Pathological Conditions, Anatomical; Lung Diseases, Obstructive; Cardiovascular Abnormalities; Vascular Malformations; Arteriovenous Malformations; Vascular Fistula; Bronchiectasis; Lung Diseases; Embolism; Infections; Communicable Diseases; Mycobacterium Infections; Hemorrhage; Fistula; Mycoses; Tuberculosis; Respiratory Tract Infections; Pulmonary Embolism; Bronchitis; Respiratory Tract Diseases; Arteriovenous Fistula; Pathologic Processes; Signs and Symptoms, Respiratory; Bronchial Diseases; Hemoptysis
• Other Study ID Numbers: 12-099

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED