Bronchoscopy in the investigation of outpatients with hemoptysis at a lung cancer clinic

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dc.check.date2019-04-12
dc.check.infoAccess to this article is restricted until 12 months after publication by request of the publisher.en
dc.contributor.authorArooj, Parniya
dc.contributor.authorBredin, Emily
dc.contributor.authorHenry, Michael T.
dc.contributor.authorKhan, Kashif A.
dc.contributor.authorPlant, Barry J.
dc.contributor.authorMurphy, Desmond M.
dc.contributor.authorKennedy, Marcus P.
dc.date.accessioned2018-05-23T14:10:12Z
dc.date.available2018-05-23T14:10:12Z
dc.date.issued2018-04-12
dc.date.updated2018-05-23T14:00:37Z
dc.description.abstractBackground: In the investigation of lung cancer, current practice in many healthcare systems would support bronchoscopy regardless of CT findings in patients with hemoptysis. We sought to identify the cause, the diagnostic yield of CT and bronchoscopy and the requirement for bronchoscopy in at risk patients with hemoptysis with a normal CT scan through our rapid access lung cancer clinic (RALC). Methods: Initially, a chart review was performed on all patients with hemoptysis (2011–2012) and thereafter a prospective analysis was performed (2013–2016). Results: Our analysis represents the largest study to date in outpatients with hemoptysis. In our retrospective study, 155 patients reported hemoptysis. Causes were lower respiratory tract infections (RTIs) (47%) and lung cancer (16%). Our prospective study included 182 patients. The causes of hemoptysis were RTIs (50%) and lung cancer (18%). There were no false negative CT-scans for lung cancer. 47/57 present with lung cancer underwent bronchoscopy and 43/47 were positive for lung cancer (92%). Patients with hemoptysis and lung cancer have a higher stage of malignancy with a predominance of squamous cell lung carcinoma. Smoking status, the duration of hemoptysis or description of hemoptysis were not predictive of lung cancer however lung cancer was not identified in patients age <50. Conclusions: One sixth of patients presenting with hemoptysis to our lung cancer clinic had lung cancer. No patient identified with cancer related haemoptysis had a CT negative for lung cancer and a combination of bronchoscopy plus endobronchial ultrasound trans-bronchial needle aspiration (EBUS-TBNA) in those patients with a CT suspicious of lung cancer is 92% sensitive for lung cancer causing hemoptysis.en
dc.description.statusPeer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationArooj, P., Bredin, E., Henry, M. T., Khan, K. A., Plant, B. J., Murphy, D. M. and Kennedy, M. P. (2018) 'Bronchoscopy in the investigation of outpatients with hemoptysis at a lung cancer clinic', Respiratory Medicine, 139, pp. 1-5. doi: 10.1016/j.rmed.2018.04.007en
dc.identifier.doi10.1016/j.rmed.2018.04.007
dc.identifier.endpage5en
dc.identifier.issn0954-6111
dc.identifier.journaltitleRespiratory Medicineen
dc.identifier.startpage1en
dc.identifier.urihttps://hdl.handle.net/10468/6180
dc.identifier.volume139en
dc.language.isoenen
dc.publisherElsevieren
dc.relation.urihttp://www.sciencedirect.com/science/article/pii/S095461111830115X
dc.rights© 2018 Elsevier Ltd. All rights reserved. This manuscript version is made available under the CC-BY-NC-ND 4.0 license.en
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/en
dc.subjectBronchoscopyen
dc.subjectCT thoraxen
dc.subjectEBUS-TBNAen
dc.subjectHemoptysisen
dc.subjectLung canceren
dc.titleBronchoscopy in the investigation of outpatients with hemoptysis at a lung cancer clinicen
dc.typeArticle (peer-reviewed)en
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