CLINICORADIOLOGICAL, ETIOLOGICAL PROFILE AND OUTCOME IN MODERATE TO MASSIVE HEMOPTYSIS IN ADMITTED PATIENTS IN A TERTIARY CARE HOSPITAL
DOI:
https://doi.org/10.69980/ty0yx606Keywords:
Hemoptysis, Massive Hemoptysis, Moderate Hemoptysis, Pulmonary Tuberculosis, BronchiectasisAbstract
Hemoptysis is the expectoration of blood from the respiratory tract and ranges from mild blood-streaked sputum to massive life-threatening bleeding. Moderate to massive hemoptysis is associated with significant morbidity and mortality, requiring prompt evaluation and management. In developing countries like India, pulmonary tuberculosis remains one of the most common causes, while bronchiectasis, bronchitis, and lung malignancy are also important etiologies. This prospective observational study aims to determine the clinicoradiological profile, etiology, and outcome of moderate to massive hemoptysis in patients admitted to a tertiary care hospital in Telangana. The study will include 100 patients presenting with true active hemoptysis who meet the inclusion criteria and are willing to participate. Patients with hematemesis, oral bleed, epistaxis, and upper respiratory tract infections will be excluded. Data collection will include detailed clinical history, physical examination, chest X-ray, computed tomography, sputum examination including CBNAAT and culture studies, and fibre optic bronchoscopy. The study will be conducted over a period of 18 months at Government General and Chest Hospital, Erragadda. The study is expected to provide valuable insights into the clinical presentation, radiological findings, underlying etiologies, and outcomes of moderate to massive hemoptysis, thereby contributing to improved diagnosis and management strategies.
References
1.D Das*, K Bhattacharjee**, C. P. T. Etiological and Clinical Profile of Patients Presenting with Hemoptysis in A Tertiary Care Teaching Hospital in North Eastern India. 2018, (2013).
2.Nawal, S. K. Hemoptysis: A Prospective Analysis of 110 Cases 1. Asian J. Biomed. Pharm. Sci. 2013 (2013).
3.Win B, R. & P S, S. Aetiology of Haemoptysis in Patients Presenting To a Tertiary Care Centre in South India. J. Evol. Med. Dent. Sci. 6, 765–769 (2017).
4.Bhalla, A., Pannu, A. K. & Suri, V. Etiology and outcome of moderate-To-massive hemoptysis: Experience from a tertiary care center of North India. Int. J. Mycobacteriology (2017). doi:10.4103/ijmy.ijmy_54_17
5.Singh, S. K. & Tiwari, K. K. Etiology of hemoptysis: A retrospective study from a tertiary care hospital from northern Madhya Pradesh, India. Indian J. Tuberc. (2016). doi:10.1016/j.ijtb.2016.02.007
6.Rachakonda, R., D V S, N. & P V, K. Study of Patients Presenting With Haemoptysis To Tertiary Care Centre. J. Evol. Med. Dent. Sci. 6, 2105–2108 (2017).
7.Patel, K. R., Patel, A. K. & Godhania, N. Evaluation of patients with haemoptysis attending the chest clinic of tertiary referral hospital. Int J Res Med 4, 2–4 (2015).
8.Chawla, R. K., Madan, A., Das, K., Chawla, A. K. & Chawla, K. Haemoptysis: The Definition Should Be Revised. Indian J. Chest Dis. Allied Sci. 57, 43 (2015).
9.Hurt, K. & Bilton, D. Haemoptysis: Diagnosis and treatment. Acute Med. (2012).
10.Pick, B. P. Gray’s Anatomy. British Medical Journal (1958). doi:10.1136/bmj.2.5099.801-e
11.Bidwell, J. L. & Pachner, R. W. Hemoptysis: Diagnosis and management. American Family Physician (2005).
12.Amirana, M. et al. An aggressive surgical approach to significant hemoptysis in patients with pulmonary tuberculosis. Am. Rev. Respir. Dis. (1968).
13.Corey, R. & Hla, K. M. Major and massive hemoptysis: Reassessment of conservative management. Am. J. Med. Sci. (1987). doi:10.1097/00000441- 198711000-00003
14.Fidan, A. et al. Hemoptysis: A retrospective analysis of 108 cases. Respir. Med. (2002). doi:10.1053/rmed.2002.1359
15.Prasad, R., Garg, R., Singhal, S. & Srivastava, P. Lessons from patients with hemoptysis attending a chest clinic in India. Ann. Thorac. Med. (2009). doi:10.4103/1817-1737.43062
16.Surendra K Sharma, A. M. Textbook of tuberculosis & nontuberculous mycobacterial diseases. (1385).
17.Talwar, D., Chudiwal, J., Jain, R. & Kumar, S. Massive hemoptysis in a respiratory ICU: causes, interventions and outcomes - Indian study. Crit. Care (2012). doi:10.1186/cc10688
18.Cederlund, K. Imaging of diseases of the chest. Acta radiol. (2010). doi:10.3109/02841851.2010.494858
19.Regnard, J. F. et al. Apergilloma: A series of 89 surgical cases. Ann. Thorac. Surg. (2000). doi:10.1016/S0003-4975(99)01334-X
20.Park, C. K. & Jheon, S. Results of surgical treatment for pulmonary aspergilloma. Eur. J. Cardio-thoracic Surg. (2002). doi:10.1016/S1010-7940(02)00104-5
21.Aspergilloma and residual tuberculous cavities—the results of a resurvey. Tubercle (1970). doi:10.1016/0041-3879(70)90015-2
22.Khan, M. A. et al. Clinical profile and surgical outcome for pulmonary aspergilloma: Nine year retrospective observational study in a tertiary care hospital. Int. J. Surg. 9, 267–271 (2011).
23.Gutierrez, G. Baum’s Textbook of Pulmonary Diseases, 7th Edition. Crit. Care (2005). doi:10.1186/cc3717
24.Salajka, F. The causes of massive hemoptysis. Monaldi Arch. Chest Dis. - Pulm. Ser. (2001).
25.Seaton, A., Seaton, D. & Leitch, A. G. Crofton and Douglas’s Respiratory Diseases: Fifth Edition. Crofton and Douglas’s Respiratory Diseases: Fifth Edition (2008). doi:10.1002/9780470695999
26.Robert J. Mason, Joel D. Ernst, Talmadge E. King Jr., Stephen C. Lazarus, John F. Murray, Jay A. Nadel, A. S. S. ; Murray & Nadel’s textbook of respiratory medicine / editor-in-chief, V. Courtney Broaddus ; editors, Robert J. Mason, Joel
D. Ernst, Talmadge E. King Jr., Stephen C. Lazarus, John F. Murray, Jay A. Nadel, Arthur S. Slutsky ; thoracic imaging editor, Micha. Murray and Nadel’s Textbook of Respiratory Medicine (2016). doi:10.1016/b978-1-4557-3383-5.00130-5
27.Michael A. Grippi, M. et al. Fishman’s pulmonary diseases and disorders / editor - in-chief, Alfred P. Fishman; co-editors, Jack A. Elias...(et al.). 5th ed. c.2015.
28.Jean-Baptiste, E. Clinical assessment and management of massive hemoptysis. Critical Care Medicine (2000). doi:10.1097/00003246-200005000-00066
29.Harrison, S. HARRISON’S Pulmonary and Critical Care Medicine.
30.Lee, B. R. et al. Analysis of patients with hemoptysis in a tertiary referral hospital. Tuberc. Respir. Dis. (Seoul). (2012). doi:10.4046/trd.2012.73.2.107
31.Reechaipichitkul, W. & Latong, S. Etiology and treatment outcomes of massive hemoptysis. Southeast Asian Journal of Tropical Medicine and Public Health (2005).
32.Hiraka, K., Matsuura, T., Goto, J., Kawano, H. & Oka, T. Bronchial Artery Embolization for Hemoptysis. IRYO - Japanese J. Natl. Med. Serv. (1996). doi:10.11261/iryo1946.50.480
33.Suri, J. C., Goel, A. & Singla, R. Cryptogenic hemoptysis: role of fiberoptic bronchoscopy. Indian J. Chest Dis. Allied Sci. (1990).
34.WHO. WHO guidelines for treatment of drug-susceptible TB and patient care: factsheet. WHO Press (2017). doi:10.1111/gean.12071
35.de Gregorio, M. A., Medrano, J., Laborda, A. & Higuera, T. Hemoptysis Workup Before Embolization: Single-Center Experience with a 15-year Period Follow-Up. Tech. Vasc. Interv. Radiol. (2007). doi:10.1053/j.tvir.2008.03.004
36.Swanson, K. L. et al. Bronchial artery embolization: Experience with 54 patients. Chest (2002). doi:10.1378/chest.121.3.789
37.Andersen, P. E. Imaging and interventional radiological treatment of hemoptysis. Acta Radiologica (2006). doi:10.1080/02841850600827577
38.Earwood, J. S. & Thompson, T. D. Hemoptysis: Evaluation and management. Am. Fam. Physician (2015).
39.Soares Pires, F., Teixeira, N., Coelho, F. & Damas, C. Hemoptysis – etiology, evaluation and treatment in a university hospital. Rev. Port. Pneumol. (English Ed. (2011). doi:10.1016/s2173-5115(11)70004-5
40.Larici, A. R. et al. Diagnosis and management of hemoptysis. Diagnostic and Interventional Radiology (2014). doi:10.5152/dir.2014.13426
41.Mal, H. et al. Immediate and long-term results of bronchial artery embolization for life-threatening hemoptysis. Chest (1999). doi:10.1378/chest.115.4.996
42.Yendamuri, S. Massive Airway Hemorrhage. Thoracic Surgery Clinics (2015). doi:10.1016/j.thorsurg.2015.04.009
43.Shin, B. S., Jeon, G. S., Lee, S. A. & Park, M. H. Bronchial artery embolisation for the management of haemoptysis in patients with pulmonary tuberculosis. Int. J. Tuberc. Lung Dis. (2011). doi:10.5588/ijtld.10.0659
44.Col, L., Mishra, A., Col, L., Mathur, A. & Kamal, B. Bronchial artery embolization in treatment of hemoptysis : Treatment efficacy and complications at a tertiary care chest centre. Med. J. Armed Forces India 1–6 (2017). doi:10.1016/j.mjafi.2017.09.001
45.Abdel-Ghany, A. F., Nassef, M. A. & Osman, N. M. Multidetector CT chest with bronchial and pulmonary angiography determining causes site and vascular origin of bleeding in patients with hemoptysis. Egypt. J. Radiol. Nucl. Med. (2013). doi:10.1016/j.ejrnm.2013.07.011
46.Fallis, A. Skandalakis Surgical Anatomy. J. Chem. Inf. Model. (2013). doi:10.1017/CBO9781107415324.004
47.Zhang, M. X. ATLAS OF HUMAN ANATOMY, 4TH EDITION. Shock (2007). doi:10.1097/01.shk.0000256134.14303.20
48.Yoon, W., Kim, J. K., Kim, Y. H., Chung, T. W. & Kang, H. K. Bronchial and nonbronchial systemic artery embolization for life-threatening hemoptysis: A comprehensive review. Radiographics (2002). doi:10.1148/rg.226015180
49.ABBOTT, O. A. The clinical significance of pulmonary hemorrhage; a study of 1316 patients with chest disease. Dis. Chest 14, 824–842 (1948).
50.Domoua, K. et al. [Hemoptysis: main etiologies observed in a pneumology department in Africa]. Rev. Pneumol. Clin. (1994).
51.Abal, A. T., Nair, P. C. & Cherian, J. Haemoptysis: Aetiology, evaluation and outcome - A prospective study in a third-world country. Respir. Med. (2001). doi:10.1053/rmed.2001.1053
52.Jindal, S. K., Gilhotra, R. & Behera, D. Fiberoptic bronchoendoscopic examination in patients with haemoptysis and normal chest roentgenogram. J. Assoc. Physicians India (1990).
53.Sharma, S. K., Dey, A. B., Pande, J. N. & Verma, K. Fiberoptic bronchoscopy in patients with haemoptysis and normal chest roentgenograms. Indian J. Chest Dis. Allied Sci. (1991).
54.Pursel, S. E. & Lindskog, G. E. Hemoptysis. A clinical evaluation of 105 patients examined consecutively on a thoracic surgical service. Am. Rev. Respir. Dis. (1961).
55.van Kralingen, K. W., van Kralingen-Heijboer, A. C., Zimmerman, M. & Postmus, P. E. Management of hemoptysis in a third world city hospital: a retrospective study. Tuber. Lung Dis. (1995). doi:10.1016/S0962-8479(05)80034-6
56.Santiago, S., Tobias, J. & Williams, A. J. A Reappraisal of the Causes of Hemoptysis. Arch. Intern. Med. (1991). doi:10.1001/ archinte.1991.00400120087015
57.Baric, D. The origin of hemoptysis in patients admitted to the pneumo-phthisiology department of the Zadar Hospital between 1970 and 1980. Bull. Int. Union Tuberc. (1984).
58.Hirshberg, B., Biran, I., Glazer, M. & Kramer, M. R. Hemoptysis: Etiology, evaluation, and outcome in a tertiary referral hospital. Chest (1997). doi:10.1378/chest.112.2.440
L.Ramakantan, R., Bandekar, V. G., Gandhi, M. S., Aulakh, B. G. & Deshmukh, H.Massive hemoptysis due to pulmonary tuberculosis: Control with bronchial artery embolization. Radiology (1996). doi:10.1148/radiology.200.3.8756916.
59..Hirshberg B, Biran I, Glazer M, Kramer MR. Hemoptysis: etiology, evaluation, and outcome in a tertiary referral hospital. Chest. 1997 Aug 1;112(2):440-4.
60.Fishman’s pulmonary diseases and disorders 6th editon Manual of practical medicine 4th edition by R.Alagappan
Downloads
Published
Issue
Section
License
Copyright (c) 2026 EPH-International Journal of Medical and Health Science
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright (c) 2026 Author
This work is licensed under a Creative Commons Attribution 4.0 International License.
