Symptoms and General Pathology

All Conditions

Respiratory Tract (Lung and Bronchial) Diseases

Infections

Neoplasms

Rare Diseases

Hemorrhage

Lung Diseases, Obstructive

Pulmonary Disease, Chronic Obstructive

Tuberculosis

Lung Neoplasms

Lung Diseases

Pneumonia

Bronchitis

Bronchiectasis

Hemoptysis

Respiratory Tract Diseases

Communicable Diseases

Respiratory Tract Infections

Chronic Disease

Disease Attributes

Mycobacterium Infections

Bacterial Infections

Gram-Positive Bacterial Infections

Mycoses

Bacterial Infections and Mycoses

Bronchial Diseases

Signs and Symptoms, Respiratory

Chronic Graft Versus Host Disease

Acute Graft Versus Host Disease

Chest X-ray

computed tomography of the chest

In patients with haemoptysis bronchoscopy will be performed with flexible bronchoscope. A systemic research of bleeding site and causes will be done. Microbiological or pathological sampling will be executed if clinically required. In selected patients, bronchoscopy might be performed with the rigid instrument or the flexible bronchoscope in intubated patients.

Bronchoscopy

Michele Mondoni, MD

Paolo Carlucci, MD

Stefano Centanni, MD, PhD

Haemoptysis is the coughing up of blood originating from the respiratory tract. It is a common and worrying clinical symptom which can be due to different aetiologies including lung cancer, tuberculosis, COPD, bronchiectasis, pneumonia, acute bronchitis or unknown origin (cryptogenic haemoptysis). Epidemiology and optimal diagnostic approach are largely unclear. Aims of this study are to define current epidemiology and to provide the best diagnostic approach by providing a diagnostic algorithm.

Epidemiology and Diagnosis of Haemoptysis: a Multicenter Study

Multicenter, Prospective, Observational Study on Epidemiology and Diagnosis of Haemoptysis

Prevalence of chronic obstructive pulmonary disease (COPD) in patients with haemoptysis will be assessed performing spirometry as described by European Respiratory Society Guidelines (European Respiratory Journal, 2005). COPD will be diagnosed in patient with a compatible clinical history (smoking history and frequent exacerbations) and the presence of a ventilatory obstructive defect as defined by a ratio of the forced expiratory volume in the first second and forced vital capacity (FEV1/FVC) \<70.

To define the prevalence of diseases in patients presenting with haemoptysis in relation to the use of drugs such as antiaggregants or anticoagulants.

To define the prevalence of diseases presenting with haemoptysis by measuring percentage of patients presenting with haemoptysis affected by lung cancer, tuberculosis, bronchiectasis, pneumonia, acute bronchitis, cryptogenic haemoptysis or other causes. Epidemiology will be analysed related to the severity of the symptom (mild haemoptysis: drops of blood or bloody sputum; moderate haemoptysis: \<500 ml/24 h, severe haemoptysis: 1-2 cups, as defined by Hirshberg et al. CHEST 1997).

Sensitivity, specificity, positive and negative predictive values of of chest X-ray, computed tomography (CT) scan and bronchoscopy executed alone versus the combination of the exams in the diagnosis of different causes of haemoptysis (lung cancer, tuberculosis, bronchiectasis, pneumonia, acute bronchitis, cryptogenic haemoptysis and other causes).

Every patient will be followed with scheduled visits and phone calls for 18 months since the first episode of haemoptysis. The percentage of patient with recurrence of haemoptysis, the severity of recurrence, will be measured and analysed by descriptive statistics.

Accuracy of bronchoscopy in localizing the side and the lobe source of the bleeding in relation to the timing of haemoptysis. The bronchoscopic findings will be analysed in relation to the timing of the bleeding (within 24 hours, between 24 and 48, 49 and 96 or over 96 hours after the occurrence of the symptom).

Every patient will be followed with scheduled visits and phone calls for 18 months since the first episode of haemoptysis. Patient survival will be measured and analysed by descriptive statistics.

University of Milan

M.D., Ph.D.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
Epidemiology and Diagnosis of Haemoptysis: a Multicenter Study	NCT02045394	Lung Cancer Tuberculosis Bronchiectasis Pneumonia Acute Bronchiti... Chronic Obstruc... Cryptogenic Hae...	Chest X-ray computed tomogr... Bronchoscopy	18 Years -	University of Milan
Epidemiology and Diagnosis of Haemoptysis: a Multicenter Study	NCT02045394	Lung Cancer Tuberculosis Bronchiectasis Pneumonia Acute Bronchiti... Chronic Obstruc... Cryptogenic Hae...	Chest X-ray computed tomogr... Bronchoscopy	18 Years -	University of Milan

Spots Global Cancer Trial Database for cryptogenic haemoptysis