New Insights Into Refractory Chronic Cough and Unexplained Chronic Cough: A 6-Year Ambispective Cohort Study.

IF 4.1 2区医学 Q2 ALLERGY

Allergy, Asthma & Immunology Research Pub Date : 2023-11-01 DOI:10.4168/aair.2023.15.6.795

Mengru Zhang, Alyn H Morice, Fengli Si, Li Zhang, Qiang Chen, Shengyuan Wang, Yiqing Zhu, Xianghuai Xu, Li Yu, Zhongmin Qiu

{"title":"New Insights Into Refractory Chronic Cough and Unexplained Chronic Cough: A 6-Year Ambispective Cohort Study.","authors":"Mengru Zhang, Alyn H Morice, Fengli Si, Li Zhang, Qiang Chen, Shengyuan Wang, Yiqing Zhu, Xianghuai Xu, Li Yu, Zhongmin Qiu","doi":"10.4168/aair.2023.15.6.795","DOIUrl":null,"url":null,"abstract":"Purpose: Only limited studies have depicted the unique features and management of refractory chronic cough (RCC) and unexplained chronic cough (UCC). These led to the initiation of this study, which reported the demographic characteristics, manifestations, and long-term outcomes on a large series of consecutive RCC/UCC patients, providing a guideline-led real-world clinical experience.Methods: Retrospective baseline information was obtained from Clinical Research Database (January 2016 to May 2021). At least 6 months after the last clinic visit, included subjects were prospectively followed up.Results: Three hundred and sixty-nine RCC and UCC patients (199 females, 53.9%) were analyzed. The median cough duration was 24.0 (12.0-72.0) months. Laryngeal symptoms were reported in 95.9% of the patients. The common triggers for coughing were talking (74.9%), pungent odors (47.3%), eating (45.5%), and cold air (42.8%). RCC was considered in 38.2%, and the remainder of 228 patients had UCC, with an equal sex distribution (P = 0.66). Among the 141 RCCs, 90.8% (128) had refractory reflux cough, which was more responsive to current treatments (P < 0.01). Although most features and test results between RCC and UCC were similar, UCC was more commonly inappropriately treated (P < 0.01). Nineteen (7.7-41.1) months after the final clinic visit, 31.2% still coughed persistently, while 68.8% reported cough improvement or remission. RCC reported more favorable treatment outcomes (including cough improvement, control, and spontaneous remission) than UCC (P < 0.01). Coughs with long duration before the initial cough clinic visit (P < 0.01), frequent urinary incontinence (P < 0.01), and being sensitive to \"talking\" (P < 0.01) or \"cold air\" (P < 0.01) were less likely to be solved.Conclusions: The current treatments only improve cough symptoms in two-thirds of patients. Clinical indicators for treatment failure were those coughing for long duration and being sensitive to \"talking\" or \"cold air.\"","PeriodicalId":7547,"journal":{"name":"Allergy, Asthma & Immunology Research","volume":"15 6","pages":"795-811"},"PeriodicalIF":4.1000,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10643855/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Allergy, Asthma & Immunology Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4168/aair.2023.15.6.795","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ALLERGY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: Only limited studies have depicted the unique features and management of refractory chronic cough (RCC) and unexplained chronic cough (UCC). These led to the initiation of this study, which reported the demographic characteristics, manifestations, and long-term outcomes on a large series of consecutive RCC/UCC patients, providing a guideline-led real-world clinical experience.

Methods: Retrospective baseline information was obtained from Clinical Research Database (January 2016 to May 2021). At least 6 months after the last clinic visit, included subjects were prospectively followed up.

Results: Three hundred and sixty-nine RCC and UCC patients (199 females, 53.9%) were analyzed. The median cough duration was 24.0 (12.0-72.0) months. Laryngeal symptoms were reported in 95.9% of the patients. The common triggers for coughing were talking (74.9%), pungent odors (47.3%), eating (45.5%), and cold air (42.8%). RCC was considered in 38.2%, and the remainder of 228 patients had UCC, with an equal sex distribution (P = 0.66). Among the 141 RCCs, 90.8% (128) had refractory reflux cough, which was more responsive to current treatments (P < 0.01). Although most features and test results between RCC and UCC were similar, UCC was more commonly inappropriately treated (P < 0.01). Nineteen (7.7-41.1) months after the final clinic visit, 31.2% still coughed persistently, while 68.8% reported cough improvement or remission. RCC reported more favorable treatment outcomes (including cough improvement, control, and spontaneous remission) than UCC (P < 0.01). Coughs with long duration before the initial cough clinic visit (P < 0.01), frequent urinary incontinence (P < 0.01), and being sensitive to "talking" (P < 0.01) or "cold air" (P < 0.01) were less likely to be solved.

Conclusions: The current treatments only improve cough symptoms in two-thirds of patients. Clinical indicators for treatment failure were those coughing for long duration and being sensitive to "talking" or "cold air."

查看原文本刊更多论文

难治性慢性咳嗽和不明原因慢性咳嗽的新认识:一项为期6年的双视角队列研究。

目的:只有有限的研究描述了难治性慢性咳嗽(RCC)和不明原因慢性咳嗽(UCC)的独特特征和治疗方法。这导致了本研究的启动，该研究报告了大量连续RCC/UCC患者的人口学特征、表现和长期结果，提供了以指南为主导的现实世界临床经验。方法:从临床研究数据库(2016年1月至2021年5月)获取回顾性基线信息。在最后一次门诊就诊后至少6个月，对纳入的受试者进行前瞻性随访。结果:分析了369例RCC和UCC患者，其中女性199例，占53.9%。咳嗽持续时间中位数为24.0(12.0 ~ 72.0)个月。95.9%的患者出现喉部症状。咳嗽的常见诱因为说话(74.9%)、刺鼻气味(47.3%)、进食(45.5%)和冷空气(42.8%)。38.2%的患者考虑为RCC，其余228例患者考虑为UCC，性别分布相等(P = 0.66)。141例rcc中，90.8%(128例)出现难治性反流性咳嗽，对目前的治疗反应较好(P < 0.01)。尽管RCC与UCC的大部分特征和检查结果相似，但UCC的不当治疗更为常见(P < 0.01)。最后一次就诊19个月(7.7 ~ 41.1)后，31.2%的患者仍持续咳嗽，68.8%的患者咳嗽改善或缓解。与UCC相比，RCC报告了更有利的治疗结果(包括咳嗽改善、控制和自发缓解)(P < 0.01)。咳嗽就诊前咳嗽时间过长(P < 0.01)、频繁尿失禁(P < 0.01)、对“说话”敏感(P < 0.01)、对“冷空气”敏感(P < 0.01)等症状解决的可能性较低。结论:目前的治疗方法只能改善三分之二患者的咳嗽症状。治疗失败的临床指标为咳嗽持续时间长，对“说话”或“冷空气”敏感。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Allergy, Asthma & Immunology Research ALLERGY-IMMUNOLOGY

CiteScore

6.10

自引率

6.80%

发文量

审稿时长

>12 weeks

期刊介绍： The journal features cutting-edge original research, brief communications, and state-of-the-art reviews in the specialties of allergy, asthma, and immunology, including clinical and experimental studies and instructive case reports. Contemporary reviews summarize information on topics for researchers and physicians in the fields of allergy and immunology. As of January 2017, AAIR do not accept case reports. However, if it is a clinically important case, authors can submit it in the form of letter to the Editor. Editorials and letters to the Editor explore controversial issues and encourage further discussion among physicians dealing with allergy, immunology, pediatric respirology, and related medical fields. AAIR also features topics in practice and management and recent advances in equipment and techniques for clinicians concerned with clinical manifestations of allergies and pediatric respiratory diseases.