The causes of haemoptysis in malaysian patients aged over 60 and the diagnostic yield of different investigations.
OBJECTIVE
In southeast Asia, pulmonary tuberculosis (TB) is the most frequently presumed diagnosis for haemoptysis. This study was designed to assess the causes of haemoptysis, the diagnostic yield of causes in different diagnostic modalities and the distribution of older patients.


METHODS
All patients presenting to the University of Malaya Medical Centre, Kuala Lumpur, Malaysia with haemoptysis were recruited prospectively and evaluated.


RESULTS
One hundred and sixty patients were evaluated for haemoptysis; 71 (44.4%) were aged 60 years or more. Significantly more patients smoked in the older age group (P = 0.002). The main causes of haemoptysis in the older patients were bronchogenic carcinoma (49.3%), pneumonia (11.3%), bronchiectasis (8.6%), cryptogenic (5.6%) and active TB (4.2%). Significantly more older patients had carcinoma (P < 0.001), while the younger patients more often had TB (P < 0.001). Chest pain was significantly more common in the older patients (P = 0.025), particularly in patients with carcinoma. Bronchoscopy alone or combined with CT of the thorax was significantly more diagnostic in the older patient (P = 0.006).


CONCLUSIONS
Bronchogenic carcinoma is the commonest cause of haemoptysis in patients aged 60 years and above. Presumptive anti-TB therapy should not be encouraged despite the regional high prevalence of TB.
Wong
Catherine Mee-Ming
CM
Department of Medicine, Faculty of Medicine, University of Malaya Medical Centre, 50603 Kuala Lumpur, Malaysia. catherin@ummc.edu.my
Lim
Kim Hatt
KH
Liam
Chong-Kin
CK
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002283:Carcinoma, Bronchogenic / Q000150:complications / Q000175:diagnosis; D015331:Cohort Studies; D005260:Female; D006469:Hemoptysis / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000150:complications / Q000175:diagnosis; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000150:complications / Q000175:diagnosis; D011336:Probability; D011379:Prognosis; D018570:Risk Assessment; D017678:Sex Distribution; D015996:Survival Rate; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000175:diagnosis