Management of life-threatening haemoptysis in an area of high tuberculosis incidence

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dc.contributor.authorGross A.M.
dc.contributor.authorDiacon A.H.
dc.contributor.authorVan Den Heuvel M.M.
dc.contributor.authorVan Rensburg J.
dc.contributor.authorHarris D.
dc.contributor.authorBolliger C.T.
dc.date.accessioned2011-05-15T16:16:46Z
dc.date.available2011-05-15T16:16:46Z
dc.date.issued2009
dc.description.abstractBACKGROUND: Emergency admissions with life-threatening haemoptysis in an area of high tuberculosis (TB) incidence at the University of Stellenbosch and Tygerberg Academic Hospital, South Africa. It is unclear if lung resection is regularly indicated to prevent recurrence following bronchial artery embolisation (BAE). OBJECTIVE: To prospectively evaluate risk factors for recurrence as selection criteria for surgery following embolisation: lack of complete cessation of haemoptysis, need for blood transfusion, presence of aspergilloma and absence of active TB. DESIGN: Prospective interventional study with 1-year follow-up. RESULTS: Within a 7-month period, 101 consecutive patients were admitted. Seven were excluded and 12 died shortly after admission. Haemoptysis ceased on medical treatment alone within 24 h in 21 of the remaining 82 patients. Their 1-year mortality was 10%. Eleven of 61 patients referred for emergency embolisation died before discharge. Of the 50 patients remaining at risk of recurrence, 38 (76%) were at low risk and 12 (24%) at high risk. Five of these patients (10% of those at risk) underwent surgery. Patients at low risk and operated patients had an uneventful course over 1 year, but two deaths occurred among the seven inoperable patients at high risk. CONCLUSION: Lung resection surgery following successful BAE for life-threatening haemoptysis can safely be avoided in patients at low risk of recurrence. © 2009 The Union.
dc.description.versionArticle
dc.identifier.citationInternational Journal of Tuberculosis and Lung Disease
dc.identifier.citation13
dc.identifier.citation7
dc.identifier.issn10273719
dc.identifier.urihttp://hdl.handle.net/10019.1/13924
dc.subjectantibiotic agent
dc.subjectanticoagulant agent
dc.subjectantitussive agent
dc.subjectsedative agent
dc.subjectadult
dc.subjectarticle
dc.subjectartificial embolism
dc.subjectaspergillosis
dc.subjectblood transfusion
dc.subjectbronchial artery
dc.subjectcontrolled study
dc.subjectemergency care
dc.subjectfemale
dc.subjecthemoptysis
dc.subjecthospital discharge
dc.subjecthuman
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectmortality
dc.subjectpriority journal
dc.subjectrecurrence risk
dc.subjectrisk factor
dc.subjecttuberculosis
dc.subjectAdult
dc.subjectChi-Square Distribution
dc.subjectEmbolization, Therapeutic
dc.subjectFemale
dc.subjectHemoptysis
dc.subjectHumans
dc.subjectIncidence
dc.subjectIntervention Studies
dc.subjectMale
dc.subjectProspective Studies
dc.subjectRisk Factors
dc.subjectSouth Africa
dc.subjectTuberculosis, Pulmonary
dc.titleManagement of life-threatening haemoptysis in an area of high tuberculosis incidence
dc.typeArticle
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