Demographic and Clinical Risk Factors of Hiccups

Background: The hiccup is a common somatic side effect of medication. Although hiccups rarely influence disease prognosis, they can reduce tolerance to medication regimens and decrease quality of life. Our previous analysis of the Japanese Adverse Drug Event Report Database identified male sex and height as factors related to hiccup risk. While the clinical features and pathogenesis of hiccups have been partially elucidated, there has been no analysis of the relation between hiccups and clinical variables, and to this end, we examined the relation among hiccups, patients’ demographics and clinical risk factors. Methods: In the present study, we conducted a more extensive examination of patient demographics, physical characteristics, primary disease, and other clinical characteristics to identify additional risk factors for medication-induced hiccups in patients hospitalized at Musashino Red Cross Hospital between April 2014 and December 2014. We conducted a statistical analysis of patient demographics, physical characteristics, and other clinical characteristics in patients with and without hiccups hospitalized at Musashino Red Cross Hospital between April 2014 and December 2014. In total, 7603 patients (> 40 years) and 2343 patients (≤ 40 years) were enrolled in the present study. Results: In the patients > 40 years, 228 exhibited hiccups. Univariate analysis indicated that male sex, tall stature, low BMI, chemotherapy, and death within 24 hours of hospitalization were related to hiccup risk. Furthermore, a multivariable analysis identified male sex, chemotherapy, low BMI, and death within 24 hours of hospitalization as independent risk factors for hiccups. Neurovascular diseases and neoplasms (of renal pelvis, brain, bile duct, bladder, esophagus, and lung/bronchus) were also identified as independent risk factors in the patients > 40 years. In the patients ≤ 40 years, most with neonatal diseases, 28 exhibited hiccups. Sex was not a significant risk factor in the patients ≤ 40 years old. Conclusions: We suggest that low BMI is a reliable physical index related to hiccup risk, while chemotherapy and certain malignant tumors are clinical risk factors. These results may assist in elucidating the underlying mechanisms and guiding therapy to reduce hiccup risk.