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Major and massive hemoptysis: reassessment of conservative management.

Publication ,  Journal Article
Corey, R; Hla, KM
Published in: Am J Med Sci
November 1987

The etiologic factors of major (greater than or equal to 200 ml/24 hr) and massive (greater than or equal to 1,000 ml/24 hr) hemoptysis may well affect the outcome and, therefore, the treatment of this often life-threatening problem. the decline in the incidence of tuberculosis (TB) and bronchiectasis, along with the increase in bronchitis and neoplasia, have led to a strong institutional bias against operating on patients with major and massive hemoptysis. A retrospective case study and an extensive literature review were undertaken to critically evaluate this policy. Fifty-nine consecutive patients with major hemoptysis, 26 of whom had massive hemoptysis, were identified from 887 patients seen in our institution over a 10-year period. Only four of these 59 patients underwent surgery, while 55 were managed conservatively. Etiologic factors, operability, and bleeding rate all appeared to play a major role in outcome. No patients with bronchitis, bronchiectasis, tuberculosis, or who were on anticoagulation therapy died compared to a mortality rate of 59% in patients with carcinoma (CA) of the lung and 71% in patients with leukemia. Eleven percent of operable patients treated conservatively died compared to a 46% mortality rate for nonoperable patients. And, 9% of patients with bleeding rates less than 1,000 ml/24 hr died compared to 58% of those with greater than or equal to 1,000 ml/24 hr. Conservative management appears to have a low mortality in patients with non-tuberculosis-related major hemoptysis as well as in many patients with massive hemoptysis, especially those patients who are operable and those without neoplastic disease.

Duke Scholars

Published In

Am J Med Sci

DOI

ISSN

0002-9629

Publication Date

November 1987

Volume

294

Issue

5

Start / End Page

301 / 309

Location

United States

Related Subject Headings

  • Tuberculosis, Pulmonary
  • Neoplasms
  • Middle Aged
  • Male
  • Lung Neoplasms
  • Humans
  • Hemoptysis
  • General & Internal Medicine
  • Female
  • Cystic Fibrosis
 

Citation

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Corey, R., & Hla, K. M. (1987). Major and massive hemoptysis: reassessment of conservative management. Am J Med Sci, 294(5), 301–309. https://doi.org/10.1097/00000441-198711000-00003
Corey, R., and K. M. Hla. “Major and massive hemoptysis: reassessment of conservative management.Am J Med Sci 294, no. 5 (November 1987): 301–9. https://doi.org/10.1097/00000441-198711000-00003.
Corey R, Hla KM. Major and massive hemoptysis: reassessment of conservative management. Am J Med Sci. 1987 Nov;294(5):301–9.
Corey, R., and K. M. Hla. “Major and massive hemoptysis: reassessment of conservative management.Am J Med Sci, vol. 294, no. 5, Nov. 1987, pp. 301–09. Pubmed, doi:10.1097/00000441-198711000-00003.
Corey R, Hla KM. Major and massive hemoptysis: reassessment of conservative management. Am J Med Sci. 1987 Nov;294(5):301–309.
Journal cover image

Published In

Am J Med Sci

DOI

ISSN

0002-9629

Publication Date

November 1987

Volume

294

Issue

5

Start / End Page

301 / 309

Location

United States

Related Subject Headings

  • Tuberculosis, Pulmonary
  • Neoplasms
  • Middle Aged
  • Male
  • Lung Neoplasms
  • Humans
  • Hemoptysis
  • General & Internal Medicine
  • Female
  • Cystic Fibrosis