Bindu Cheriattil Govindan
BACKGROUND Haemoptysis is a common but alarming symptom. The causes are numerous and may vary depending on the population studied. This study aimed to find the cause of haemoptysis among patients attending a tertiary care setting in south India. To assess the mortality rate attributable to haemoptysis and the relation between disease and severity of haemoptysis. MATERIALS AND METHODS A prospective cross-sectional study was done. 409 patients with haemoptysis were evaluated by careful history taking, clinical examination, and investigated as per conventional methods and in selected cases using fibreoptic bronchoscopy and CT scan of chest. RESULTS The commonest cause of haemoptysis in the study group is pulmonary tuberculosis and its sequelae (n=206, 50.3%). Lung tumours (n=58, 14.9%) formed second major cause of haemoptysis. Among them 51 were proven cases of carcinoma lung (12.5 bronchiectasis of non-tuberculous origin (n=16, 3.9%), pneumonias (n=18, 4.4%) lung abscess (n=16, 3.9%), among 409 patients there was a total mortality of 4.8% (n=20). Death attributable to haemoptysis was 2.4% (n=10). Among them 80% (n=8) had massive haemoptysis and 20% (m=2) had moderate haemoptysis at the time of presentation. CONCLUSION Pulmonary tuberculosis with its sequelae was the commonest cause of haemoptysis (50.6%), followed by carcinoma lung (14.9%) in this study. Among the total patients who expired (n=20) 40% patients had massive haemoptysis. 114 patients with haemoptysis had a CXR which appeared normal or non-localizing (27%). In 69 patients (16.8%) it could be considered as cryptogenic haemoptysis, in whom no diagnosis could be obtained in spite of adequate investigation.
