Analysis Of Risk Factors For Massive Hemoptysis

Objective: Massive hemoptysis is one of the life-threatening symptoms with a high mortality rate.There are few studies and data about the risk factors of massive hemoptysis patients in domestic.The aim of this study is to explore the potential risk factors of massive hemoptysis patients,improve doctors’ understanding of massive hemoptysis and improve the prognosis of hemoptysis patients.Methods: The clinical data of hemoptysis patients in the Department of Respiratory and Critical Care Medicine of the First People’s Hospital of Neijiang from November 2017 to September 2022 were retrospectively analyzed.According to the amount of hemoptysis and prognosis,they were divided into massive hemoptysis group and medium or small hemoptysis group.By comparing the general demographic characteristics,clinical manifestations,laboratory tests and imaging findings of the two groups of patients,the possible risk factors were found out through single factor analysis,and the risk factors of massive hemoptysis were obtained by logistic regression analysis.The predictive efficacy of the risk factors was evaluated by the receiver operating curve.Results: A total of 180 hemoptysis patients were included,including 57 patients with massive hemoptysis and 123 patients with moderate or medium hemoptysis.Univariate analysis found that the characteristic of hemoptysis was pure blood,heart rate,percentage of neutrophils,ground-glass density shadow around the lesion,diameter of the left bronchial artery,diameter of the right bronchial artery,and diameter of the largest bronchial artery might be related to massive hemoptysis.Multivariate logistic regression analysis showed that the increase of the diameter of the left bronchial artery(OR=3.134)and the diameter of the right bronchial artery(OR=10.661)were independent risk factors for massive hemoptysis.The diameter of the left bronchial artery has a general predictive value for massive hemoptysis(AUC=0.724),while the diameter of the right bronchial artery has a higher predictive value for large hemoptysis(AUC=0.945).The best cutoff value was the diameter of left bronchial artery 1.9 mm,sensitivity 0.8,specificity 0.515;When the diameter of the right bronchial artery is 2.75 mm,the sensitivity is 0.96 and the specificity is 0.842.Conclusion: The enlargement of bronchial artery diameter is an independent risk factor for patients with massive hemoptysis.If there is enlarged bronchial artery in patients with hemoptysis,early treatment and intervention may reduce the occurrence of massive hemoptysis.