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咯血的病因、诊断方法及短期预后——卡塔尔一家三级医疗中心的回顾性横断面研究

Etiology, diagnostic modalities, and short-term outcomes of hemoptysis-a retrospective cross-sectional study from a tertiary care center in Qatar.

作者信息

Ahmed Shakeel, Hameed Mansoor, Al-Tikriti Mustafa, Elfert Khaled, Hussein Mousa, Albakri Mutaz, Singh Rajvir, Ul Haq Irfan, Ahmad Mushtaq, Thomas Merlin

机构信息

Department of Respiratory Medicine, Al Wakra Hospital, Al Wakra, Qatar.

Department of Chest, Hamad General Hospital, Doha, Qatar.

出版信息

J Thorac Dis. 2023 Dec 30;15(12):6634-6643. doi: 10.21037/jtd-23-939. Epub 2023 Dec 9.

Abstract

BACKGROUND

Hemoptysis is a concerning symptom characterized by the expectoration of blood from the respiratory tract, which can range from mild to life-threatening. It can be caused by various underlying conditions. Accurate diagnosis is critical for effective management. The causes of hemoptysis can vary depending on geographic location and the population's composition. In this study, we aimed to examine the etiology, diagnostic methods, and short-term outcomes of hemoptysis in Qatar, focusing on data from Hamad General Hospital (HGH), which serves as a major tertiary care center in the country. Qatar has a diverse and dynamic population, primarily composed of expatriate workers, especially from South Asia. Previous data on hemoptysis in Qatar was collected between 1997 and 2007, when the population was considerably smaller and less diverse. Given the substantial growth in population and diversity since then, this study sought to provide updated information on the causes and outcomes of hemoptysis in the region.

METHODS

This is a retrospective single center observational data review from the largest tertiary care center of Qatar, HGH. Patients who presented to HGH from 01/07/2015 to 30/06/2018 with hemoptysis were included in the study. Descriptive and summary statistics were described and analyzed using SPSS version 23.

RESULTS

A total of 172 patients met the inclusion criteria. Most of the patients were male (74.4%) with a mean age of 37.9±16.4 years. South Asians (43.6%) accounted for the majority followed by Qatari nationals (20.3%). Mild hemoptysis was recorded in 89.5% of patients while only 3.5% had severe hemoptysis. The mean duration of hemoptysis was 1.72±0.72 days. The most common etiology was respiratory infection in 72.6% of the patients followed by tuberculosis (TB) and bronchiectasis 7% each. All patients were managed with observation or antimicrobials except two of the patients with severe hemoptysis who required bronchial artery embolization (BAE). There were no reports of recurrence of hemoptysis or deaths until hospital discharge.

CONCLUSIONS

Respiratory infection is the most common cause of hemoptysis at our center. Mild hemoptysis is the major presentation and the majority improved with conservative treatment.

摘要

背景

咯血是一种令人担忧的症状,其特征是呼吸道咳出血液,严重程度不一,从轻微到危及生命。它可能由多种潜在疾病引起。准确诊断对于有效治疗至关重要。咯血的病因可能因地理位置和人群构成而异。在本研究中,我们旨在研究卡塔尔咯血的病因、诊断方法和短期预后,重点关注作为该国主要三级医疗中心的哈马德总医院(HGH)的数据。卡塔尔人口多样且动态变化,主要由外籍工人组成,尤其是来自南亚的工人。卡塔尔此前关于咯血的数据是在1997年至2007年期间收集的,当时人口规模小得多且多样性较低。鉴于自那时以来人口大幅增长和多样性增加,本研究旨在提供该地区咯血病因和预后的最新信息。

方法

这是一项对卡塔尔最大的三级医疗中心哈马德总医院进行的回顾性单中心观察数据审查。纳入研究的患者为2015年7月1日至2018年6月30日期间因咯血就诊于哈马德总医院的患者。使用SPSS 23版对描述性和汇总统计数据进行描述和分析。

结果

共有172名患者符合纳入标准。大多数患者为男性(74.4%),平均年龄为37.9±16.4岁。南亚人(43.6%)占多数,其次是卡塔尔国民(20.3%)。89.5%的患者记录为轻度咯血,而只有3.5%的患者有严重咯血。咯血的平均持续时间为1.72±0.72天。最常见的病因是呼吸道感染,占患者的72.6%,其次是结核病(TB)和支气管扩张症,各占7%。除两名严重咯血患者需要进行支气管动脉栓塞术(BAE)外,所有患者均接受观察或使用抗菌药物治疗。直至出院,无咯血复发或死亡报告。

结论

呼吸道感染是我们中心咯血最常见的原因。轻度咯血是主要表现,大多数患者通过保守治疗得到改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1043/10797390/7b9ba8825cef/jtd-15-12-6634-f1.jpg

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