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28 February 2018

Is Bronchoscopy Always Justified in Diagnosis of Haemoptysis?

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1
Department of Pneumology and Allergy, 1st Chair of Internal Medicine, Medical University of Lodz, 90-153 Lodz, Poland
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Student of Medical Division, Medical University of Łódź, 90-153 Lodz, Poland
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Department of General and Oncological P ulmonology, Medical University of Łódź, 90-153 Lodz, Poland
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Author to whom correspondence should be addressed.

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.

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