Umapathi, S (2020) Causes and Outcome of Moderate to Massive Hemoptysis among admitted patients from Rajiv Gandhi Government General Hospital in Chennai. Masters thesis, Madras Medical College, Chennai.
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Abstract
BACKGROUND: Successful management of hemoptysis depends upon amount of blood loss, identification of cause and type of management. OBJECTIVES: 1. To evaluate the relative frequency of different causes of hemoptysis. 2. To assess the short term outcome of various managements. METHODS: A single centre prospective observational study carried out on 93 patients admitted with hemoptysis in a tertiary care teaching hospital of South India for a period of 7 months from 1st December 2018 to 30th June 2019. Detailed clinical history, radiological evaluation, bronchoscopy, serology, sputum or bronchial wash analysis were done to establish the cause. All the patients were initially managed conservatively by using intravenous fluids, antibiotics, anti-tussives and antifibrinolytic drugs. Bronchial artery embolization or surgery was performed for ongoing bleeding. All the patients were followed up till 3 months from discharge. RESULTS: Among 93 patients included in this study, 71 were males and 22 were females. Male to female ratio was 3.22:1. Maximum number of patients were seen in 41-50 years age group. Mean age was 45.74 years with standard deviation of 10.663. Majority of the patients (76.3%) had moderate hemoptysis while severe was present in 14 (15.1%) patients and only 8 (8.6%) patients had massive hemoptysis. Pulmonary tuberculosis (active and sequelae) was the most common cause of hemoptysis associated in 68 (73.1%) patients with 30 (32.3%) patients having active pulmonary tuberculosis. Bronchiectasis was the second commonest cause (8.6%) followed by aspergilloma (6.5%), carcinoma lung (5.4%), pneumonia (3.2%), lung abscess (2.2%) and pulmonary vasculitis (1.1%). Diabetes mellitus was found in 18 (19.4%) out of 93 patients. 66 patients (71%) responded to conservative management. 27 (29%) patients underwent intervention out of which 23 (85%) underwent bronchial artery embolization and remaining 4 (15%) underwent surgery. Massive hemoptysis had poor outcome (50%). CONCLUSION: Pulmonary tuberculosis is still the most common cause of hemoptysis. To prevent recurrent hemoptysis interventional management were in high position.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | 201727003 |
| Uncontrolled Keywords: | Hemoptysis, Recurrent, Tuberculosis, Bronchiectasis. |
| Subjects: | MEDICAL > Tuberculosis and Respiratory Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 04 Feb 2021 15:47 |
| Last Modified: | 04 Feb 2021 15:47 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/13803 |
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