Seasonal Variation in Cryptogenic and Noncryptogenic Hemoptysis Hospitalizations in France

doi:10.1378/chest.118.2.440

Chest

Volume 118, Issue 2, August 2000, Pages 440-444

https://doi.org/10.1378/chest.118.2.440 Get rights and content

Study objective

To determine the potential role of seasonality in hospitalizations for cryptogenic and noncryptogenic hemoptysis in the French population.

Design

Retrospective analysis of hospital discharge data from a National Register.

Setting

All 29 French university hospitals, between July 1, 1994, and June 30, 1997.

Patients

Two thousand six hundred seventy-seven and 3,672 adult hospitalizations for cryptogenic and other hemoptysis, respectively.

Measurements

Cumulative monthly averages were determined, expressed as the percentage above or below the average monthly value during the entire study period.

Results

The distribution of cumulative monthly hospitalizations for cryptogenic hemoptysis peaked in March (32% above the average) and was lowest in summer (30% below the average; p < 0.001). Hospitalizations for noncryptogenic hemoptysis followed a similar seasonal pattern (p < 0.001). In the 16- to 34-year-old individuals, cryptogenic hemoptysis, compared with noncryptogenic hemoptysis, showed a higher incidence with a larger seasonal amplitude (p < 0.001).

Conclusions

A better understanding of the fundamental pathophysiologic mechanisms underlying this respiratory and hemorrhagic condition may be helpful in developing preventive measures, especially in patients with a risk of recurrence.

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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Chest

Clinical Investigations: HemoptysisSeasonal Variation in Cryptogenic and Noncryptogenic Hemoptysis Hospitalizations in France

Study objective

Design

Setting

Patients

Measurements

Results

Conclusions

Section snippets

Study Population

Results

Discussion

Conclusion

ACKNOWLEDGMENTS

Chest

Chest

Lancet

Lancet

Changing spectrum of hemoptysis: underlying causes in 148 patients undergoing diagnostic fiberoptic bronchoscopy

Arch Intern Med

A reappraisal of the causes of hemoptysis

Arch Intern Med

Hemoptysis: indications for bronchoscopy

Arch Intern Med

Cryptogenic hemoptysis: clinical features, bronchoscopic findings, and natural history in 67 patients

Ann Intern Med

Seasonal trends in US asthma hospitalizations and mortality

JAMA

Clinical Investigations: Hemoptysis
Seasonal Variation in Cryptogenic and Noncryptogenic Hemoptysis Hospitalizations in France