Hemoptysis: a 10-year retrospective study

Abstract

Background: Hemoptysis is uncommon in pediatric practice. We reviewed 10 years of experience with hemoptysis in a tertiary pediatric hospital to identify patient characteristics and predictors of mortality.

Methods: Patients were divided into four age groups (0 to 5, 6 to 10, 11 to 20, and >20 years). Hemoptysis was defined as mild (<150 mL/day), large (150 to 400 mL/day), or massive (>400 mL/day). Fever was defined as >/=38.5 degrees C.

Results: A total of 228 patients (115 males and 113 females) with 246 episodes of hemoptysis were identified and grouped according to primary diagnosis. There were 149 patients in the cystic fibrosis (CF) group, 37 in the congenital heart disease (CHD) group, and 42 in the Other group. Age was significantly higher in the CF group compared with the CHD and Other groups. Length of stay was significantly prolonged in the CF group compared with the Other group. The overall mortality was 13%. After initial analysis, mortality predictors were age, amount of hemoptysis, receipt of blood products, and fever. After stratification, we found: 1) in the >20-year age group, there was a difference in mortality when comparing CF patients with CHD patients; 2) for patients who received blood products, there were differences in mortality in patients with CF, CHD, and Other diagnoses; 3) for patients who received blood, there were differences in mortality only for the 0- to 5-year age group; and 4) the amount of hemoptysis was predictive for mortality only in CHD patients.

Conclusions: Hemoptysis presented in young adult CF patients and in adolescent CHD patients. Young adult CF patients with hemoptysis had a higher risk of mortality compared with young adult CHD patients. The amount of hemoptysis predicted mortality only for CHD patients. Receiving blood products was predictive of mortality for all patients.