Avaliar doentes admitidos por hemoptises quanto à etiologia, meios diagnósticos, tratamento e evolução.

Realizou-se um estudo retrospectivo dos doentes admitidos no Hospital de São João, por hemoptises, entre 01 de Janeiro de 2004 e 31 de Dezembro de 2008.

Foram estudados 237 doentes, com idade média de 57.9 anos. Nos doentes com idade inferior a 18 anos, os diagnósticos mais frequentes foram Bronquiectasias e Cardiopatia congénita. Nos adultos, as Sequelas de Tuberculose Pulmonar e as Bronquiectasias foram os diagnósticos predominantes (22.2% e 15.8%, respectivamente), seguidos pela neoplasia pulmonar. A infecção foi responsável pelas perdas hemáticas em 51 doentes, essencialmente Tuberculose Pulmonar, Pneumonia e Traqueobronquite. A etiologia ficou por esclarecer em 6.3%.

Todos os doentes realizaram radiografia de tórax. A TAC foi realizada em 81.4% dos doentes e a Broncofibroscopia em 52.7%, esta última localizando a fonte da hemorragia em 38.4% e estabelecendo diagnóstico definitivo em 17.6%.

Na maioria dos casos (90.7%), a hemorragia foi controlada com tratamento médico. Ao longo destes 5 anos, 11.8% dos doentes foram submetidos a embolização arterial, sendo a prevenção de recidiva o principal motivo da sua realização.

Foram registados 14 óbitos (5,9%), sendo identificados, como factores de mau prognóstico, a instabilidade hemodinâmica e a etiologia neoplásica.

As hemoptises continuam a ser um sintoma frequente, sendo actualmente as sequelas associadas a infecções crónicas e as neoplasias as principais etiologias. Neste estudo, os factores de pior prognóstico foram a instabilidade hemodinâmica e a etiologia neoplásica.

Evaluate patients admitted for hemoptysis, its etiology, use of diagnostic tests, treatment and outcome.

A retrospective analysis was done, checking clinical files of patients admitted for hemoptysis, between 1st January 2004 and 31st December 2008.

Two hundred and thirty seven patients were included in this study, with a mean age of 57.9 years. In patients under 18 years, the most frequent diagnoses were Bronchiectasis and Congenital Cardiopathy. In adults, Pulmonary Tuberculosis Sequelae and Bronchiectasis were the dominant diagnoses (22.2% and 15.8%, respectively), followed by Lung Cancer. Active infection was responsible for bleeding in 51 patients, especially Pulmonary Tuberculosis, Pneumonia and Tracheobronchitis. The etiology of hemoptysis was not established in 6.3%.

All patients performed chest X-Ray. Chest CT was performed in 81.4% of patients and Fiberoptic bronchoscopy in 52.7%, the latter locating the source of bleeding in 38.4% and establishing a final diagnosis in 17.6%.

In most patients, effective control of bleeding was achieved by medical treatment (90.7%).

During these 5 years, arterial embolization was performed in 11.8% of patients. The main reason for embolization was recurrence prevention.

There were 14 deaths (5.9%), being identified as poor prognostic factors, hemodynamic instability and malignancy.

Hemoptysis is still a frequent symptom, being chronic infection sequelae and lung cancer their main causes. In this study, factors associated with a worse prognosis were hemodynamic instability and malignancy.