Abstract
BackgroundCough is a common presenting symptom in patients with Idiopathic Pulmonary Fibrosis (IPF). This study measured cough rates in IPF patients and investigated the association between cough and measures of health related quality of life and subjective cough assessments. In addition, IPF cough rates were related to measures of physiological disease severity and compared to cough rates in health and other respiratory conditions.MethodsNineteen IPF patients, mean age 70.8 years ± 8.6, five female (26.3%) were studied. Subjects performed full pulmonary function testing, 24 hour ambulatory cough recordings, completed a cough related quality of life questionnaire (Leicester Cough Questionnaire) and subjectively scored cough severity with a visual analogue scale. Ambulatory cough recordings were manually counted and reported as number of coughs per hour.ResultsThe 24hr cough rates were high (median 9.4, range 1.5-39.4), with day time rates much higher than night time (median 14.6, range 1.9-56.6 compared to 1.9, range 0-19.2, p = 0.003). Strong correlations were found between objective cough frequency and both the VAS (day r = 0.80, p < 0.001, night r = 0.71, p = 0.001) and LCQ (r = -0.80, p < 0.001), but not with measures of pulmonary function. Cough rates in IPF were higher than healthy subjects (p < 0.001) and asthma patients (p < 0.001) but similar to patients with chronic cough (p = 0.33).ConclusionsThis study confirms objectively that cough is a major, very distressing and disabling symptom in IPF patients. The strong correlations between objective cough counts and cough related quality of life measures suggest that in IPF patient's, perception of cough frequency is very accurate.
Highlights
Cough is a common presenting symptom in patients with Idiopathic Pulmonary Fibrosis (IPF)
Subjects Nineteen patients were recruited from two specialist Interstitial Lung Disease (ILD) clinics at University Hospital Aintree (UHA) and University Hospital South Manchester (UHSM)
Relationships between Objective Cough Frequency, Cough VAS and Quality of Life Strong correlations were found between objective cough frequency and both the cough VAS and cough related quality of life, see table 2 and Figure 2
Summary
Cough is a common presenting symptom in patients with Idiopathic Pulmonary Fibrosis (IPF). IPF cough rates were related to measures of physiological disease severity and compared to cough rates in health and other respiratory conditions. Idiopathic Pulmonary Fibrosis (IPF) is a progressive fibrotic disease of unknown aetiology with an estimated incidence of 6-20 cases per 100,000 of the population. Cough in IPF, is both a presenting and a complicating clinical feature [2]. Swigris et al conducted in-depth interviews with IPF patients to determine how the disease affects their lives [3]. They described cough as being dry, nonproductive and hacking with significant physical and social impacts
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