DIFFERENCES IN PULMONARY AND EXTRA-PULMONARY CAUSES OF HEMOPTYSIS

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Background: Hemoptysis is the coughing up of blood from the tracheobronchial tree. Hemoptysis is most often a manifestation of lung diseases. The etiology of hemoptysis can also be extra-pulmonary. A certain number of cases are idiopathic. The gold standard in the diagnosis is computed tomography, pulmonary angiography, and aortography. The treatment of hemoptysis is the treatment of the underlying disease and, if necessary, bronchoscopy. Methodology: This study examines 235 patients presenting with hemoptysis at the Emergency Center of Serbia, University Clinical Center, focusing on demographics, comorbidities, diagnostic procedures, and treatment outcomes. Patients underwent thorough clinical evaluation and laboratory tests, with an emphasis on distinguishing pulmonary from non-pulmonary causes. Descriptive and inferential statistics were employed to analyze the data, revealing significant findings. Results: Results showed a male predominance (62.1%) with an average age of 60.9 years. Comorbidities, particularly arterial hypertension, were prevalent. Chest imaging, including X-rays and CT scans, aided in diagnosing conditions such as pulmonary thromboembolism and malignancy. Logistic regression highlighted predictors for outpatient treatment, including higher hemoglobin levels and non-pulmonary etiology. Bronchoscopy was performed in 23.8% of cases, revealing varied findings, including active bleeding, inflammation, and bronchiectasis. Notably, uncontrolled arterial hypertension emerged as a leading cause of hemoptysis. Patients with pulmonary causes exhibited distinct clinical and laboratory profiles compared to those with non-pulmonary etiologies. Conclusion: This study underscores the heterogeneity of hemoptysis etiologies and the critical role of thorough evaluation in guiding treatment decisions. Understanding the differences in clinical characteristics and laboratory results between pulmonary and non-pulmonary causes informs optimal management strategies and balancing outpatient vs. inpatient care.

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