Clinical Characteristics and Short-Term Outcomes of Adult Patients Presenting to the Emergency Department with Hemoptysis: A Retrospective Cohort Study

Objective: This study aimed to characterize the clinical profile of adults presenting with hemoptysis to the emergency department (ED), describe short-term clinical outcomes and their distribution across predefined FLHASc risk strata, and explore patterns of healthcare resource utilization within this cohort.
Material and Methods: This retrospective cohort study included consecutive adults presenting with hemoptysis to the ED of (blinded for review), Türkiye, between June 1, 2019, and December 31, 2024. Patients were categorized as low risk (FLHASc=0) or moderate-to-high risk (FLHASc≥1). Primary outcomes were 28-day mortality, intensive care unit (ICU) admission, and invasive mechanical ventilation (IMV).
Results: Of 322 screened patients, 258 were analyzed (mean age 62.1±17.8 years; 74% male): 63 (24.4%) were low risk and 195 (75.6%) were moderate-to-high risk. Pure bright-red hemoptysis and active malignancy occurred only in the higher-risk group (62.6% vs. 0%; 23.6% vs. 0%; both p<0.001). Lobar consolidation predominated in low-risk patients (52.4% vs. 25.1%; p<0.001). Overall 28-day all-cause mortality was 9.3%, with a numerically higher rate in the moderate-to-high-risk group (11.3% vs. 3.2%; p=0.094). ICU admission (11.3% vs. 9.5%) and IMV (13.3% vs. 7.9%) rates were numerically higher in the moderate-to-high-risk group without reaching statistical significance.
Conclusion: In this retrospective cohort, predefined FLHASc risk categories were associated with differences in clinical presentation, imaging findings, and short-term outcome distribution. These findings provide descriptive insight into risk patterns within a mixed-etiology emergency department population. Prospective multicenter studies are required before conclusions can be drawn regarding predictive performance or clinical implementation.

Keywords: Computed tomography; emergency department; hemoptysis; mortality; risk stratification