Clinical efficacy of early and delayed fiberoptic bronchoscopy in patients with hemoptysis.

We analyzed the records of 129 consecutive patients with hemoptysis to evaluate whether or not early (during hemoptysis or during the 48 h after hemoptysis stopped) fiberoptic bronchoscopy (FB) more frequently localized and/or diagnosed the source of bleeding and influenced clinical outcome than delayed FB (48 h or more after hemoptysis stopped). Patients were divided into 3 groups on the basis of their final diagnoses: neoplasm (31 patients), bronchitis/bronchiectasis (52 patients), and miscellaneous (46 patients). Although the likelihood of visualizing active bleeding (41 versus 8%) or its site (34 versus 11%) was significantly higher with early versus delayed FB, respectively, neither active bleeding nor a bleeding site were visualized in at least 60% of the 92 patients who underwent early FB. Definitive (endoscopic) diagnoses by early or delayed FB occurred primarily in patients with neoplasm. Clinical outcome based on the results of FB was not significantly different between the early and delayed groups. Thus, early, single FB was generally neither diagnostic nor therapeutically decisive in these patients with hemoptysis.