Long-term prognosis of chronic cough: a prospective, observational cohort study

Heikki O Koskela,Anne M Lätti,Minna K Purokivi

doi:10.1186/s12890-017-0496-1

Heikki O Koskela, Anne M Lätti + Show 1 more

Open Access

https://doi.org/10.1186/s12890-017-0496-1

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Abstract

BackgroundThe long-term prognosis of chronic cough and its determinants need to be clarified.MethodsThis is a prospective, observational cohort study. Eighty-nine unselected subjects with chronic (> 8 weeks’ duration) cough were carefully investigated: Clinical examination, symptom questionnaire, Leicester Cough Questionnaire (LCQ), skin prick tests, ambulatory peak expiratory flow monitoring, spirometry before and after 0.4 mgs of salbutamol, exhaled nitric oxide concentration measurement, hypertonic saline cough provocation test, and histamine bronchial provocation test. After five years, a letter was sent to the subjects containing questions about continuation of cough, smoking, indoor exposures, presence of co-morbidities, and current medication. It also contained LCQ and Cough Clinic diagnostic questionnaire. Sixty-eight subjects (76%) responded.ResultsAt five years, continuing regular cough was present in 31 (46%) of the subjects and continuing impairment in cough-related quality of life (less than 1.3 points’ improvement in LCQ) in 32 (47%). Continuing regular cough was associated with presence of chronic rhinitis or esophageal reflux disease, baseline mild airway responsiveness to histamine, and baseline strong cough responsiveness to hypertonic saline. Continuing impairment in cough-related quality of life was associated with high body mass index, absence of atopy, absence of pets, and high number of background disorders (esophageal reflux disease, asthma, or chronic rhinitis).ConclusionsAlmost half of subjects with chronic cough suffered of the disorder at five years from initial assessment. Several possible determinants of poor prognosis could be identified.

Highlights

The long-term prognosis of chronic cough and its determinants need to be clarified
Cough is a clinically highly important symptom. It is the most common reason why people seek medical attention [1, 2] and has a strong negative effect on the quality of life (QoL) [3, 4].This is especially true about chronic cough, defined as cough which lasts longer than eight weeks [5, 6]
The present study showed that almost half of the subjects with chronic cough continue coughing regularly after five years

Summary

Introduction

The long-term prognosis of chronic cough and its determinants need to be clarified. Cough is a clinically highly important symptom. It is the most common reason why people seek medical attention [1, 2] and has a strong negative effect on the quality of life (QoL) [3, 4].This is especially true about chronic cough, defined as cough which lasts longer than eight weeks [5, 6]. Knowledge about the long-term prognosis of chronic cough and its determinants would be valuable to guide the management of subjects with chronic cough. To the best of our knowledge there is only one study about the long-term prognosis of chronic cough [7].

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Discussion

Conclusion