open access

Vol 86, No 1 (2018)
ORIGINAL PAPERS
Published online: 2018-02-28
Submitted: 2017-11-08
Accepted: 2018-01-29
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Is bronchoscopy always justified in diagnosis of haemoptysis?

Justyna Maria Torbiarczyk, Patryk Aleksander Sobczak, Katarzyna Krystyna Torbiarczyk, Joanna Miłkowska-Dymanowska, Adam Antczak, Paweł Górski, Adam J. Białas, Wojciech J. Piotrowski
DOI: 10.5603/ARM.2018.0004
·
Pubmed: 29490417
·
Adv Respir Med 2018;86(1):13-16.

open access

Vol 86, No 1 (2018)
ORIGINAL PAPERS
Published online: 2018-02-28
Submitted: 2017-11-08
Accepted: 2018-01-29

Abstract

Introduction: Fiber-optic bronchoscopy (FOB) is commonly performed in the first line in diagnostic process of haemoptysis.
However, lots of evidences suggest that in haemoptysis FOB do not always provide additional, useful information to radiological
diagnostics. Therefore, this study aimed to evaluate the validity of performing FOB as a method of choice in first line diagnostics
of haemoptysis.

Material and methods: Data comprised consecutively collected results from patients referred for FOB assessment for clinical
purposes were retrospectively analysed. We included all examinations, which were performed due to haemoptysis as the only
indication, excluding any other lung-related conditions.

Results: 114 patients were finally included to the study. The median age was 59 (IQR: 46–64.75). Active bleeding was visualized
during examination of 13 (11.4%) patients. Patients with active bleeding did not differ significantly according to age: 59 (54–69)
vs 59 (45–64) years; W = 532.5, p-value = 0.27, and gender: c2 = 1.68, p-value = 0.2. On the other hand, in 29 (25.44%)
patients, FOB revealed no visible abnormalities. This subgroup of patients was significantly younger — 46 (34–62) years vs 60
(53–67) years; W = 782, p-value = 0.003.

Conclusion: Low number of visualized active bleeding sites suggest overuse of bronchoscopy in diagnosis of haemoptysis. Indications
for this examination should be reconsidered especially in young patients with non-massive haemoptysis.

Abstract

Introduction: Fiber-optic bronchoscopy (FOB) is commonly performed in the first line in diagnostic process of haemoptysis.
However, lots of evidences suggest that in haemoptysis FOB do not always provide additional, useful information to radiological
diagnostics. Therefore, this study aimed to evaluate the validity of performing FOB as a method of choice in first line diagnostics
of haemoptysis.

Material and methods: Data comprised consecutively collected results from patients referred for FOB assessment for clinical
purposes were retrospectively analysed. We included all examinations, which were performed due to haemoptysis as the only
indication, excluding any other lung-related conditions.

Results: 114 patients were finally included to the study. The median age was 59 (IQR: 46–64.75). Active bleeding was visualized
during examination of 13 (11.4%) patients. Patients with active bleeding did not differ significantly according to age: 59 (54–69)
vs 59 (45–64) years; W = 532.5, p-value = 0.27, and gender: c2 = 1.68, p-value = 0.2. On the other hand, in 29 (25.44%)
patients, FOB revealed no visible abnormalities. This subgroup of patients was significantly younger — 46 (34–62) years vs 60
(53–67) years; W = 782, p-value = 0.003.

Conclusion: Low number of visualized active bleeding sites suggest overuse of bronchoscopy in diagnosis of haemoptysis. Indications
for this examination should be reconsidered especially in young patients with non-massive haemoptysis.

Get Citation

Keywords

fiber-optic bronchoscopy, FOB, haemoptysis, diagnostic procedures

About this article
Title

Is bronchoscopy always justified in diagnosis of haemoptysis?

Journal

Advances in Respiratory Medicine

Issue

Vol 86, No 1 (2018)

Pages

13-16

Published online

2018-02-28

DOI

10.5603/ARM.2018.0004

Pubmed

29490417

Bibliographic record

Adv Respir Med 2018;86(1):13-16.

Keywords

fiber-optic bronchoscopy
FOB
haemoptysis
diagnostic procedures

Authors

Justyna Maria Torbiarczyk
Patryk Aleksander Sobczak
Katarzyna Krystyna Torbiarczyk
Joanna Miłkowska-Dymanowska
Adam Antczak
Paweł Górski
Adam J. Białas
Wojciech J. Piotrowski

References (14)
  1. Jeudy J, Khan AR, Mohammed TL, et al. Expert Panel on Thoracic Imaging. ACR Appropriateness Criteria hemoptysis. J Thorac Imaging. 2010; 25(3): W67–W69.
  2. Ayed A. Pulmonary resection for massive hemoptysis of benign etiology. Eur J Cardiothorac Surg. 2003; 24(5): 689–693.
  3. Dugosh JW. Ph D. Hemoptysis. Salem Press Encycl Health. 2017.
  4. Sakr L, Dutau H. Massive hemoptysis: an update on the role of bronchoscopy in diagnosis and management. Respiration. 2010; 80(1): 38–58.
  5. Gasparini S. Indications for diagnostic bronchoscopy in adults. Monaldi Arch Chest Dis. 2011; 75(1): 24–31.
  6. Nielsen K, Gottlieb M, Colella S, et al. Bronchoscopy as a supplement to computed tomography in patients with haemoptysis may be unnecessary. Eur Clin Respir J. 2016; 3: 31802.
  7. Leiten EO, Martinsen EM, Bakke PS, et al. Complications and discomfort of bronchoscopy: a systematic review. Eur Clin Respir J. 2016; 3: 33324.
  8. Thirumaran M, Sundar R, Sutcliffe IM, et al. Is investigation of patients with haemoptysis and normal chest radiograph justified? Thorax. 2009; 64(10): 854–856.
  9. Davoodi M, Kordi M, Gharibvand MM, et al. Hemoptysis: comparison of diagnostic accuracy of multi detector CT scan and bronchoscopy. Glob J Health Sci. 2015; 7(3): 373–377.
  10. Tsoumakidou M, Chrysofakis G, Tsiligianni I, et al. A prospective analysis of 184 hemoptysis cases: diagnostic impact of chest X-ray, computed tomography, bronchoscopy. Respiration. 2006; 73(6): 808–814.
  11. Earwood JS, Thompson TD. Hemoptysis: evaluation and management. Am Fam Physician. 2015; 91(4): 243–249.
  12. Bønløkke S, Guldbrandt LM, Rasmussen TR. Bronchoscopy in patients with haemoptysis and normal computed tomography of the chest is unlikely to result in significant findings. Dan Med J. 2015; 62(8): A5123.
  13. Sharma SK, Dey AB, Pande JN, et al. Fiberoptic bronchoscopy in patients with haemoptysis and normal chest roentgenograms. Indian J Chest Dis Allied Sci. 1991; 33(1): 15–18.
  14. Set PA, Flower CD, Smith IE, et al. Hemoptysis: comparative study of the role of CT and fiberoptic bronchoscopy. Radiology. 1993; 189(3): 677–680.

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