Bronchoscopy to Evaluate Hemoptysis in Older Men with Nonsuspicious Chest Roentgenograms: Methods

The reports of all bronchoscopic examinations done at the Minneapolis Veterans Administration Medical Center hospital and clinic from Jan 1, 1979, through Dec 31, 1987, were reviewed. Charts were obtained and reviewed on all potentially eligible patients. Medical histories and final diagnoses were obtained from the attending physicians’ notes, and chest roentgenograms were classified according to the radiologists report. Eligible patients included men more than 40 years old who underwent fiberoptic bronchoscopy for hemoptysis of any amount with a nonsuspicious chest roentgenogram, defined as one without definite mass, infiltrate (including diffuse interstitial disease), cavity, lobar atelectasis, or large pleural reaction or effusion. This definition is similar to that used in earlier studies. Patients were excluded if they had a previous history of lung cancer.

During the study period, fiberoptic bronchoscopy was done using local anesthesia and routinely included a thorough examination of the upper airway and tracheobronchial tree, including washings to obtain material for cytologic study, AFB and KOH slides, and mycobacterial and fungal culture. Brushings and forceps biopsies were done as indicated. No specific protocol was used to follow-up patients after bronchoscopy, but follow-up information was usually available by chart review.
Statistical analysis was by Fishers exact and Students t tests. add comment
One hundred six men more than 40 years old (mean age, 61 years) underwent fiberoptic bronchoscopy for hemoptysis and a nonsuspicious chest roentgenogram during the study period. Most patients had no more than 5 ml per day of hemoptysis, and many of these reported only “flecks” or “streaks.” Mean smoking history was 54 pack-years, and 89 percent of the patients had a smoking history of at least 20 pack-years.

Category: Bronchoscopy

Tags: bronchoscopy, chest roentgenogram, hemoptysis, lung cancer