Management of Massive Hemoptysis: Analyses of 58 Patients

Turk Thorac J. 2016 Oct;17(4):148-152. doi: 10.5152/TurkThoracJ.2016.002. Epub 2016 Oct 1.


Objectives: The objective was to describe changing patterns of etiological factors and treatment modalities for massive hemoptysis.

Material and methods: From January 2008-December 2012, the medical records of 58 massive hemoptysis patients were reviewed.

Results: Fifty-eight patients, 44 were men (75.9%) and 14 were women (24.1%), with a mean age of 51.4 years (range= 19-84 years), were divided into three groups; surgical management (n= 37, 63.8%), conservative management (n= 14, 24.1%) and bronchial artery embolization (n= 6, 10.4%). One case (1.7%) had combined treatment modality; bronchial artery embolization was followed by surgical resection. Anatomical lung resections were the most preferred resection type in the surgical management group (n= 34, 91.9%). The most common etiological factor was bronchiectasis (n= 19, 32.8%); followed by bronchial cancer (n= 14, 24.1%). The duration of hospitalization in the surgical management group was 11.4 days (range= 4-24); whereas in the bronchial artery embolization group, hospitalization was only four days (range= 2-7) (p< 0.01). Prolonged air leak (n= 7; 18.9%) was the most common complication in the surgical management group.

Conclusion: We emphasize that bronchiectasis was leading cause of massive hemoptysis. Surgical treatment remains the definitive therapy in the management of massive hemoptysis with decreased mortality rates over decades; whereas bronchial artery embolization is an effective therapeutic tool.

Keywords: Hemoptysis; bronchiectasis; surgical management; tuberculosis.