• Ramon Orriols, Víctor Núñez, Rosana Hernando, Estrella Drobnic, and Margarita Moreiras.
• Servei de Pnemologia, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España. rorriols@vhebron.net
• Med Clin (Barc). 2012 Sep 8; 139 (6): 255-60.

Background And ObjectivesThe natural history of life-threatening hemoptysis (LTH), a medical emergency, is ill defined. The objective of the study was to evaluate, in a university teaching hospital setting, the etiology, methods used, and evolution of LTH.Patients And MethodsProspective study in which we enrolled 154 patients admitted for LTH over 3 consecutive years. Bronchoscopy and arteriography procedures were performed, as prescribed by the attending physician. Patient evolution was followed 5 years post-event.Result79.2% were male. Average age was 57 (SD 15) years. Bronchiectasis and active tuberculosis and its consequences were the predominant etiologies. A total of 4.5% patients died as a result of LTH. Bronchoscopy was more effective in identifying the bleeding than arteriography when the examination was performed during an episode of hemoptysis (84.2 versus 20.4%) (P<.001). When embolization or bronchoscopy were used as first measure, embolization was more effective in stabilizing bleeding than bronchoscopy (87 versus 53.5%) (P<.001) in admitted patients. LTH relapse was 10.7%, while it was lower with embolization.ConclusionsLeading causes were bronchiectasis and tuberculosis. While bronchoscopy during a hemoptysis episode was effective in identifying the source of the bleeding, artery embolization was more effective in stabilizing the patient both at the short and long term.Copyright © 2011 Elsevier España, S.L. All rights reserved.

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