Independent association of younger age with hemoptysis in adults with pulmonary tuberculosis

BACKGROUND: The risk factors for mild to moderate hemoptysis in patients with pulmonary tuberculosis (PTB) are not entirely clear. OBJECTIVE: To evaluate the independent association of risk factors with the occurrence of hemoptysis in PTB patients. DESIGN: Cross-sectional study of adult patients newly diagnosed with microbiologically proven PTB in a New York City hospital. Patients were categorized into subjects with and without hemoptysis and compared using univariate analysis. Independent associations of variables with hemoptysis were estimated using multivariate logistic regression. RESULTS: Of 194 subjects with PTB, 44 (23%) had hemoptysis. In univariate analysis, subjects with hemoptysis were significantly younger (P = 0.003), and more likely to be undocumented foreign-born (P = 0.038) compared to subjects without hemoptysis. In multivariate analysis, only younger age was independently associated with hemoptysis. This association was significant for a continuous decrease in age per year, or per decade (adjusted OR 1.59, P = 0.003). CONCLUSIONS: Younger age is an independent risk factor for hemoptysis in PTB. It is conceivable that a stronger inflammatory response in younger than in older age could contribute to pulmonary pathogenesis and injury in PTB.