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Long-term prognostic outcomes in patients with haemoptysis
Respiratory Research ( IF 4.7 ) Pub Date : 2021-08-04 , DOI: 10.1186/s12931-021-01809-6
Michele Mondoni 1 , Paolo Carlucci 1 , Giuseppe Cipolla 2 , Matteo Pagani 3 , Francesco Tursi 4 , Alessandro Fois 5 , Pietro Pirina 5 , Sara Canu 5 , Stefano Gasparini 6 , Martina Bonifazi 6 , Silvia Marani 7 , Andrea Comel 8 , Laura Saderi 9 , Sabrina De Pascalis 1 , Fausta Alfano 1 , Stefano Centanni 1 , Giovanni Sotgiu 9
Affiliation  

Haemoptysis is a challenging symptom that can be associated with potentially life-threatening medical conditions. Follow-up is key in these patients to promptly detect new or misdiagnosed pathologic findings. Few prospective studies have evaluated long-term prognostic outcomes in patients with haemoptysis. Furthermore, the role played by antiplatelet and anticoagulant drugs on mortality and recurrence rates is unclear. The aim of this study was to assess mortality after 18 months of follow-up. Furthermore, the incidence of recurrence and the risk factors for recurrence and death were evaluated (including the role played by anticoagulant and antiplatelet drugs). Observational, prospective, multicentre, Italian study. 451/606 (74.4%) recruited patients with haemoptysis completed the 18 months follow-up. 22/604 (3.6%) diagnoses changed from baseline to the end of the follow-up. 83/604 (13.7%) patients died. In 52/83 (62.7%) patients, death was the outcome of the disease which caused haemoptysis at baseline. Only the diagnosis of lung neoplasm was associated with death (OR (95%CI): 38.2 (4.2–347.5); p-value: 0.0001). 166 recurrences were recorded in 103/604 (17%) patients. The diagnosis of bronchiectasis was significantly associated with the occurrence of a recurrence (OR (95% CI): 2.6 (1.5–4.3)); p-value < 0.0001). Anticoagulant, antiaggregant, and anticoagulant plus antiaggregant drugs were not associated with an increased risk of death and recurrence. Our study showed a low mortality rate in patients with haemoptysis followed-up for 18 months. Pulmonary malignancy was the main aetiology and the main predictor of death, whereas bronchiectasis was the most frequent diagnosis associated with recurrence. Antiplatelet and/or anticoagulant therapy did not change the risk of death or recurrence. Follow-up is recommended in patients initially diagnosed with lower airways infections and idiopathic bleeding. Trial registration: NCT02045394

中文翻译:

咯血患者的长期预后结果

咯血是一种具有挑战性的症状,可能与可能危及生命的医疗状况有关。随访是这些患者及时发现新的或误诊的病理结果的关键。很少有前瞻性研究评估咯血患者的长期预后结果。此外,抗血小板和抗凝药物对死亡率和复发率的作用尚不清楚。本研究的目的是评估随访 18 个月后的死亡率。此外,还评估了复发的发生率以及复发和死亡的危险因素(包括抗凝和抗血小板药物的作用)。观察性、前瞻性、多中心、意大利研究。451/606 (74.4%) 招募的咯血患者完成了 18 个月的随访。22/604 (3. 6%) 诊断从基线变化到随访结束。83/604 (13.7%) 名患者死亡。在 52/83 (62.7%) 患者中,死亡是导致基线咯血的疾病的结果。只有肺肿瘤的诊断与死亡相关(OR(95%CI):38.2(4.2-347.5);p 值:0.0001)。在 103/604 (17%) 名患者中记录了 166 次复发。支气管扩张的诊断与复发的发生显着相关(OR(95% CI):2.6(1.5-4.3));p 值 < 0.0001)。抗凝剂、抗凝剂和抗凝剂加抗凝剂药物与死亡和复发风险增加无关。我们的研究显示咯血患者随访 18 个月的死亡率较低。肺部恶性肿瘤是主要病因和死亡的主要预测因子,而支气管扩张是与复发相关的最常见的诊断。抗血小板和/或抗凝治疗没有改变死亡或复发的风险。建议对最初诊断为下呼吸道感染和特发性出血的患者进行随访。试用注册:NCT02045394
更新日期:2021-08-04
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