Clinical characteristics and prognosis of acute pulmonary embolism with hemoptysis in autoimmune disease patients

Abstract

Abstract Background Hemoptysis is prevalent in acute pulmonary embolism (PE) and holds a significant bearing on clinical decision-making. Although PE is increasingly reported in autoimmune disease patients, few studies have examined the association between acute PE with hemoptysis and autoimmune disease.Methods This retrospective study evaluated autoimmune disease patients presenting with acute PE and hemoptysis at Peking Union Medical College Hospital (PUMCH) between January 2012 and October 2020. Hemoptysis and non-hemoptysis patients were compared, and autoimmune disease patients were compared to those without autoimmune disease. Clinical characteristics, PE risk stratification, hemoptysis amount, initial anticoagulation management, and prognosis were analyzed descriptively.Results The study analyzed 896 patients diagnosed with acute pulmonary embolism, of which 105 (11.7%) presented with hemoptysis. Hemoptysis was often associated with autoimmune diseases, with a younger patient population, lower-risk PE, and milder volume of hemoptysis. Most patients received therapeutic-dose anticoagulation, and the autoimmune disease subgroup had a higher survival rate (97.5%) compared to the non-autoimmune subgroup (82.8%) with statistical significance (p = 0.022). Patients were grouped based on maximum daily blood volume and PE risk stratification, receiving different treatments and having a hierarchical prognosis.Conclusions It is crucial to consider the underlying cause of hemoptysis in acute PE diagnosis and effectively treat the primary autoimmune disease. Therapeutic decisions should balance PE risk stratification and hemoptysis volume.