Early Prediction of In-Hospital Mortality of Patients with Hemoptysis: An Approach to Defining Severe Hemoptysis

Background: The severity of hemoptysis is usually assessed on the amount of blood expectorated, although no threshold has been agreed upon. Respiratory or hemodynamic failures are additional severity criteria but occur in few cases. Objectives: Early identification of the in-hospital mortality determinants might be helpful to best characterize severe hemoptysis. Methods: This is a retrospective cohort study of consecutive patients with hemoptysis admitted to the ICU of a teaching hospital during a 14-year period. The model for early prediction of in-hospital mortality was developed on a derivation sample (67% of patients) using multiple logistic regression. Calibration and discrimination of the model were tested using the remaining validation sample. A scoring system was developed for clinical use. Results: The in-hospital mortality of the 1,087 patients (age 54 years, 71% male) was 6.5% (95% CI 5–8). Chronic alcoholism, cancer or aspergillosis, pulmonary artery involvement, infiltrates involving two quadrants or more on the admission radiograph, and meReceived: April 5, 2011 Accepted after revision: August 4, 2011 Published online: October 19, 2011 Muriel Fartoukh, MD Service de Pneumologie et Réanimation, Hôpital Tenon Assistance Publique – Hôpitaux de Paris 4 Rue de la Chine , FR–75020 Paris (France) Tel. +33 15 601 6574, E-Mail muriel.fartoukh @ tnn.aphp.fr © 2011 S. Karger AG, Basel 0025–7931/12/0832–0106$38.00/0 Accessible online at: www.karger.com/res For editorial comment see p. 99 D ow nl oa de d by : 54 .7 0. 40 .1 1 11 /2 3/ 20 17 1 1: 50 :3 5 P M