ROLE OF COMORBID RISK FACTORS OF TUBERCULOSIS IN BRONCHIAL ARTERY EMBOLISATION FOR MANAGING MASSIVE HAEMOPTYSIS
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 81
Abstract
BACKGROUND Among the multiple causes of haemoptysis, active tuberculosis (TB), chronic inflammatory lung diseases due to bronchiectasis, aspergilloma within a chronic sarcoid or tuberculous cavity are the most common cause of haemoptysis in developing countries. Several diseases increase the risk of tuberculosis causing increased morbidity and mortality among these patients. The following study was intended to evaluate the role of comorbid risk factors in bronchial artery embolisation (BAE) for managing haemoptysis. MATERIALS AND METHODS 282 patients who presented with massive haemoptysis were included in the study, 141 over a period of 2 years from April 2012 to April 2014. Further followup of all the patients for 2 years from April 2014 to April 2016 by dividing the patients based on tuberculosis and comorbid risk factors. Recurrent bleeding and mortality were evaluated among the patients. RESULTS 55 patients (40%) with tuberculosis, 28.3% of patients with bronchiectasis and fibrocavitary lesion of lung, 7.8% of patients with aspergilloma underwent BAE. Comorbid risk factors mainly were DM in 15.6% and HIV in 9.9% of patients. Haemoptysis free survival rate in TB patients along with comorbid risk factors were 64.4%, 55.2% and 41.2% in 6, 12 and 24 months respectively. Whereas in non-tuberculous conditions it was 81.3%, 77.1% and 68.1% in 6, 12 and 24 months respectively and in tuberculosis alone without any risk factors it was 98.1%, 91.2% and 88.1% in 6, 12 and 24 months respectively which showed a statistical significance (p= 0.05). Mortality rate was significantly high in TB along with comorbid risk conditions group when compared to the rest of the groups (p= 0.05). CONCLUSION Prognosis of the TB patients without comorbid risk factors were good when compared to TB along with risk factors for BAE for massive haemoptysis. The risk factors namely diabetes mellitus (DM), human immunodeficiency virus (HIV), chronic liver diseases, chronic renal diseases and coronary artery diseases not only play an important in the activation of latent infection, but also causes increased mortality in these patients. So these risk factors can also be considered as comorbidities in these patients increasing the risk of recurrent haemoptysis and mortality of patients undergoing BAE for massive haemoptysis.
Authors and Affiliations
Kalyan Kumar P. V, Ramakrishna Gorantla
Keywords
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- EP ID EP275349
- DOI 10.14260/jemds/2017/1240
- Views 95
- Downloads 0
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