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Clinical Investigations: HemoptysisSeasonal Variation in Cryptogenic and Noncryptogenic Hemoptysis Hospitalizations in France
Section snippets
Study Population
We analyzed retrospectively the French teaching hospital discharge register between July 1, 1994, and June 30, 1997. This data set includes all discharges from all teaching hospitals in France. These 29 teaching hospitals represent 47,531 short-stay/acute-care beds, or 28.3% of public-hospital capacity in France in 1996.
The Anonymous Hospital Discharge Data Set is abstracted from information collected at discharge from patient medical records. The rules of the database exclude redundant entries
Results
During the 3-year study period, spontaneous hemoptysis was reported as the discharge diagnosis for 6,349 adult hospitalizations.
Lung cancer (n = 949, 14.9%), bronchiectasis (n = 558, 8.8%), chronic bronchitis (n = 543, 8.6%), and acute bronchitis or pneumonia (n = 427, 6.7%) were among the most frequently identified etiologies. Other causes (n = 1,195, 18.8%) were cardiovascular conditions (71%), other respiratory conditions (15.5%), hemorrhagic diathesis (11.8%), and systemic diseases (1.7%).
Discussion
Several main findings emerged from this study. First, spontaneous cryptogenic hemoptysis necessitating hospitalization in France peaked in late winter and early spring (peak in March), both in the overall population and in subgroups defined by age and sex. Second, patients with cryptogenic hemoptysis were younger than those with noncryptogenic hemoptysis, and for persons 16 through 34 years of age, cryptogenic hemoptysis hospitalizations exhibited a larger seasonal amplitude. Third,
Conclusion
The seasonal periodicity of cryptogenic and noncryptogenic hemoptysis hospitalizations clearly demonstrated by these epidemiologic data showing a peak incidence in winter and early spring months, has important implications. Future questions include whether it might be advisable to inform susceptible patients of the increased risk during winter and early spring. Further community-based or prospective studies are required to better understand the fundamental pathophysiologic mechanisms underlying
ACKNOWLEDGMENTS
The authors thank the Conférences des Présidents de Commission Médicale d’Etablissement et des Directeurs Généraux de Centres Hospitaliers Universitaires for providing us with data from the PMSI CHU database and Prof. Pierre Dujols of the Medical Information Department of Montpellier University Hospitals who maintains the database. We thank Dr. Colette Dahan for critical reading of the manuscript and Ms. Rasson for preparing the manuscript.
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