The predicative clinical features associated with chronic cough that has a single underlying cause.

Jul 23, 2020

Contributor: Kefang Lai,Wenzhi Zhan,Hu Li,Fang Yi,Wen Peng,Jianmeng Zhou,Jiaman Tang,Liting Zhang,Li Long,Ruchong Chen,Wei Luo,Qiaoli Chen, MeiJiang,Nanshan Zhong

The predicative clinical features associated with chronic cough that has a single underlying cause.

Few studies have investigated the usefulness of the clinical characteristics of cough in the diagnosis of chronic cough.
To evaluate the diagnostic value of clinical characteristics and concomitant symptoms of chronic cough in predicting its cause． METHODS: We recruited adult patients with chronic cough as a primary presenting symptom and identified those with a single underlying cause. Clinical features of cough were recorded with a custom-designed questionnaire and its relationship with cause of cough were analyzed.
A total of 1162 patients with a single underlying cause were enrolled. Nocturnal cough alone was a predictor of cough variant asthma [odds ratio (OR) 2.037, 95% CI 1.003-4.139] with high specificity (97.6%) and low sensitivity (8.1%). Heartburn (OR 2.671, 95% CI 1.544-4.620), belching (OR 2.536, 95% CI 1.620-3.971), acid regurgitation (OR 2.043, 95% CI 1.299-3.212) indicated gastroesophageal reflux-related cough with high specificity (85.5%-94.9%) and low sensitivity (22.8%-40.7%). Cough after meals had a high specificity (91.2%) and a low sensitivity (24.8%) for gastroesophageal reflux-related cough. Postnasal dripping (OR 2.317, 95% CI 1.425-3.767) and history of sinusitis (OR 4.137, 95% CI 2.483-6.892) were indicators for upper airway cough syndrome with high specificity (80.8% and 90.2% respectively). Rhinitis/sinusitis-related symptoms showed moderate sensitivity (72.9%), however, they showed mild specificity (46.1%) for upper airway cough syndrome.
Cough timing, several concomitant symptoms associated with gastroesophageal reflux or rhinitis/sinusitis, and medical history are useful to indicate common causes of chronic cough.

Copyright © 2020. Published by Elsevier Inc.

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About The Expert

Kefang Lai

State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510120, P.R.China. Electronic address: klai@163.com.

Wenzhi Zhan

State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510120, P.R.China.

Hu Li

State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510120, P.R.China.

Fang Yi

State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510120, P.R.China.

Wen Peng

State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510120, P.R.China.

Jianmeng Zhou

State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510120, P.R.China.

Jiaman Tang

State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510120, P.R.China.

Liting Zhang

State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510120, P.R.China.

Li Long

State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510120, P.R.China.

Ruchong Chen

State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510120, P.R.China.

Wei Luo

State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510120, P.R.China.

Qiaoli Chen

State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510120, P.R.China.

MeiJiang

State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510120, P.R.China.

Nanshan Zhong

State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510120, P.R.China.

References

PubMed