ĐẶC ĐIỂM LÂM SÀNG BỆNH NHÂN HO RA MÁU TẠI BỆNH VIỆN ĐẠI HỌC Y DƯỢC THÀNH PHỐ HỒ CHÍ MINH

Abstract

Background: Hemoptysis is a common clinical symptom in internal medicine practice and is always considered an important warning sign. The severity of hemoptysis can range from coughing up blood-streaked sputum to life-threatening, requiring urgent assessment and treatment. The mortality rate in massive hemoptysis ranges from 9% to 38%. Identifying the cause and severity of hemoptysis is crucial for timely diagnosis and treatment, helping to reduce complications and mortality. In Vietnam, there have not been many published studies on hemoptysis. Therefore, the survey of clinical characteristics of patients with hemoptysis at the University of Medicine and Pharmacy Hospital, Ho Chi Minh City will contribute to supplementing domestic data, supporting the direction of diagnosis of causes and appropriate treatment strategies in the context of clinical practice in Vietnam. Objectives: To investigate the clinical, laboratory test, radiological characteristics of patient with hemophytis. Methods: A retrospective, descriptive study was carried out on 104 hemophytis patients with treated as inpatients at University Medical Center Ho Chi Minh City from November 2019 to November 2023. The patients were recorded demographic information, clinical symptoms, clinical examination, blood test results, chest X-ray. Data were collected through review of medical records. Results: Among 104 patients enrolled in the study, the median age was 61 years and males accounted for the majority 56.7%. Regarding co-morbidities in the study, we recorded the prevalence of hypertension at 56.7%, history of pulmonary tuberculosis (22%), bronchiectasis (17%). The most common clinical symptom was productive cough, followed by dyspnea (23.1%) and chest pain (17.3%). The most common physical sign was crackles (27.9%). Mild hemoptysis was the most frequent severity level, comprising 61.5% of hospitalized cases. Among cases of moderate or severe hemoptysis, the primary diagnoses were bronchiectasis and pulmonary tuberculosis. Chest X-rays revealed abnormalities in 86 patients, with fibrotic lesions being the most common finding. Notably, over 50% of these radiographic abnormalities were attributed to bronchiectasis. The most common etiologies of hemoptysis identified in this study were bronchiectasis (29%) and respiratory tract infection (21%), followed by pulmonary tuberculosis (19%) and lung cancer (11%). Conclusion: Our study reported the characteristics of patients had hemoptysis with high mean ages and male predominance. Hypertension and a history of pulmonary tuberculosis, and bronchiectasis are the three most common comorbidities. The most common symptoms were productive cough, dyspnea, and chest pain. Most hospitalized cases presented with mild hemoptysis. Radiographically, pulmonary fibrosis was the most common finding. The leading causes of hemoptysis, in order of prevalence, were bronchiectasis, lower respiratory tract infection, pulmonary tuberculosis, and lung cancer.