• Muriel Fartoukh, Babak Khoshnood, Antoine Parrot, Antoine Khalil, Marie-France Carette, Annabelle Stoclin, Charles Mayaud, Jacques Cadranel, and Pierre Yves Ancel.
• INSERM, UMR S953, IFR 69, Epidemiological Research on Perinatal Health and Women's and Children's Health, UPMC-University of Paris 6, and Département de Santé Publique, Hôpital Tenon, Assitance Publique-Hôpitaux de Paris, Paris, France. muriel.fartoukh@tnn.aphp.fr
• Respiration. 2012 Jan 1; 83 (2): 106-14.

BackgroundThe severity of hemoptysis is usually assessed on the amount of blood expectorated, although no threshold has been agreed upon. Respiratory or hemodynamic failures are additional severity criteria but occur in few cases.ObjectivesEarly identification of the in-hospital mortality determinants might be helpful to best characterize severe hemoptysis.MethodsThis is a retrospective cohort study of consecutive patients with hemoptysis admitted to the ICU of a teaching hospital during a 14-year period. The model for early prediction of in-hospital mortality was developed on a derivation sample (67% of patients) using multiple logistic regression. Calibration and discrimination of the model were tested using the remaining validation sample. A scoring system was developed for clinical use.ResultsThe in-hospital mortality of the 1,087 patients (age 54 years, 71% male) was 6.5% (95% CI 5-8). Chronic alcoholism, cancer or aspergillosis, pulmonary artery involvement, infiltrates involving two quadrants or more on the admission radiograph, and mechanical ventilation at referral predicted independently mortality. The model showed good concordance between predicted and observed probabilities of death and good discrimination (receiver operating characteristic curve area 0.87; 95% CI 0.82-0.92). The model-based score (chronic alcoholism, pulmonary artery involvement, and radiographic patterns, 1 point each; cancer, aspergillosis, and mechanical ventilation, 2 points each) predicted the probability of death as follows: score 0, 1%; score 1, 2%; score 2, 6%; score 3, 16%; score 4, 34%; score 5, 58%; score 6, 79%, and score 7, 91%.ConclusionsOur results provide useful information about the short-term prognosis of patients with hemoptysis, which could help design therapeutic approaches and management plans according to the risk of in-hospital mortality.Copyright © 2011 S. Karger AG, Basel.

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