Clinical Characteristics And Etiological Analysis Of 133 Patients For Pulmonary Embolism Combined With Hemoptysis

Objective: In the patients with pulmonary embolism(PE),PE itself can cause hemoptysis and other reasons can also cause hemoptysis.For the patients of PE combined with hemoptysis,the clinical characteristics and the causes of hemoptysis need to be analyzed in different situations.Methods: A retrospective analysis was performed in a teaching hospital.We screened 583 PE patients and hemoptysis occurred in 141 cases.Due to anticoagulation-related hemoptysis or data unavailable,133 cases were enrolled in final analysis(127 acute PE and 6 chronic PE).We classified the acute PE patients who combined with diseases which can cause hemoptysis to non-simple group(n =61)and those without these diseases to simple group(n =66).Results: The incidence of hemoptysis in PE patients was 23.75%.In the simple group,the volume of hemoptysis ≤ 5 ml was 80.30%(53/66),and ≤ 20 ml was 90.91%(60/66).In the non-simple group who combined with lung cancer,the volume of hemoptysis ≤ 5 ml was 68.4%(26/38)and≤ 20 ml was 86.8%(33/38).Further analyses showed that the volume ofhemoptysis in the non-simple group was larger than that in the simple group(median 5 [5-125] vs.5 [5-5],P=0.000;volume ≥ 100 ml: 29.5% vs.6.1%,P=0.000).Among all the PE patients,chronic thromboembolic pulmonary hypertension(CTEPH),PE combined with tuberculosis(TB)and PE combined with bronchiectasis were independent risk factors for the volume of hemoptysis ≥ 100 ml(OR =15.00,(95% CI: 2.235-100.652);12.00,(3.101-46.437);60.00,(6.552-549.441),respectively).Conclusions: The hemoptysis caused by acute PE or PE combined with lung cancer had the characteristics of blood in sputum and mild hemoptysis.PE combined with TB,bronchiectasis and CTEPH are associated with moderate to massive hemoptysis,indicating that the risk of hemoptysis ≥ 100 ml would obviously increase.