Noeul Kang, Ha-Kyeong Won, Ji-Hyang Lee, Ji-Su Shim, Sung-Yoon Kang, Han-Ki Park, Eun-Jung Jo, Seung Eun Lee, Min-Hye Kim, Sang-Heon Kim, Sae-Hoon Kim, Yoon-Seok Chang, Byung-Jae Lee, Woo-Jung Song, Min-Woo Jo
{"title":"慢性咳嗽的健康相关生活质量及其决定因素:韩国慢性咳嗽登记研究","authors":"Noeul Kang, Ha-Kyeong Won, Ji-Hyang Lee, Ji-Su Shim, Sung-Yoon Kang, Han-Ki Park, Eun-Jung Jo, Seung Eun Lee, Min-Hye Kim, Sang-Heon Kim, Sae-Hoon Kim, Yoon-Seok Chang, Byung-Jae Lee, Woo-Jung Song, Min-Woo Jo","doi":"10.4168/aair.2023.15.3.348","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Chronic cough (CC) is associated with health-related quality of life (HRQoL) impairment. However, the determinants of HRQoL are under-investigated.</p><p><strong>Methods: </strong>Patients aged 19-80 years with CC were prospectively recruited from 10 referral clinics. Comparisons were made with age- and sex-matched controls (1:4 ratio) selected from a Korean general population survey database; 1) a group without current cough (non-cough controls) and 2) another group without major chronic illnesses (healthy controls). HRQoL was assessed using the EuroQoL 5-dimension (EQ-5D) index. In CC patients, cough-specific patient-reported outcomes (PROs) were additionally measured. Cross-sectional analyses were performed to evaluate demographic and clinical parameters associated with the EQ-5D index of CC patients.</p><p><strong>Results: </strong>A total of 200 CC patients (137 newly referred with CC and 63 refractory or unexplained CC [RUCC] patients), 800 non-cough controls, and 799 healthy controls were analyzed. The EQ-5D index of CC patients was significantly lower than that of non-cough controls or healthy controls (0.82 ± 0.14 vs 0.92 ± 0.14/0.96 ± 0.08; <i>P</i> < 0.001, respectively). The index was also associated with older age (≥ 60 years), female sex, and comorbidities such as asthma or depression. Among the patients with CC, the index was significantly lower in patients with RUCC than in those with newly referred CC, being treated with codeine or cough neuromodulators, or with cough-related fatigue. In Spearman analyses, the EQ-5D index correlated with cough-specific quality of life and cough severity scores, not with throat sensation or cough trigger scores.</p><p><strong>Conclusions: </strong>The HRQoL impairment of CC patients was associated with older age, female sex, and comorbidities but it was also affected by cough severity, complications, treatments, and treatment responses. 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The EQ-5D index of CC patients was significantly lower than that of non-cough controls or healthy controls (0.82 ± 0.14 vs 0.92 ± 0.14/0.96 ± 0.08; <i>P</i> < 0.001, respectively). The index was also associated with older age (≥ 60 years), female sex, and comorbidities such as asthma or depression. Among the patients with CC, the index was significantly lower in patients with RUCC than in those with newly referred CC, being treated with codeine or cough neuromodulators, or with cough-related fatigue. In Spearman analyses, the EQ-5D index correlated with cough-specific quality of life and cough severity scores, not with throat sensation or cough trigger scores.</p><p><strong>Conclusions: </strong>The HRQoL impairment of CC patients was associated with older age, female sex, and comorbidities but it was also affected by cough severity, complications, treatments, and treatment responses. 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引用次数: 3
摘要
目的:慢性咳嗽(CC)与健康相关生活质量(HRQoL)损害相关。然而，HRQoL的决定因素尚未得到充分研究。方法:前瞻性地从10个转诊诊所招募19-80岁的CC患者。与从韩国普通人口调查数据库中选择的年龄和性别匹配的对照组(1:4)进行比较;1)目前没有咳嗽的一组(非咳嗽对照组)和2)另一组没有重大慢性疾病(健康对照组)。HRQoL采用EuroQoL 5维(EQ-5D)指数进行评估。在CC患者中，还测量了咳嗽特异性患者报告的结果(PROs)。横断面分析评估与CC患者EQ-5D指数相关的人口学和临床参数。结果:共分析了200例CC患者(137例新转诊CC, 63例难治性或不明原因CC [RUCC]患者)，800例无咳嗽对照，799例健康对照。CC患者的EQ-5D指数显著低于非咳嗽对照组和健康对照组(0.82±0.14 vs 0.92±0.14/0.96±0.08;P < 0.001)。该指数还与年龄较大(≥60岁)、女性和合并症(如哮喘或抑郁症)相关。在CC患者中，RUCC患者的指数明显低于新转诊CC、接受可待因或咳嗽神经调节剂治疗或咳嗽相关疲劳的患者。在斯皮尔曼的分析中，EQ-5D指数与咳嗽特异性生活质量和咳嗽严重程度评分相关，而与喉咙感觉或咳嗽触发评分无关。结论:CC患者的HRQoL损害与年龄、女性、合并症有关，但也受咳嗽严重程度、并发症、治疗和治疗反应的影响。为了进一步了解和改善CC患者的HRQoL，有必要进行纵向研究。
Health-Related Quality of Life and Its Determinants in Chronic Cough: The Korean Chronic Cough Registry Study.
Purpose: Chronic cough (CC) is associated with health-related quality of life (HRQoL) impairment. However, the determinants of HRQoL are under-investigated.
Methods: Patients aged 19-80 years with CC were prospectively recruited from 10 referral clinics. Comparisons were made with age- and sex-matched controls (1:4 ratio) selected from a Korean general population survey database; 1) a group without current cough (non-cough controls) and 2) another group without major chronic illnesses (healthy controls). HRQoL was assessed using the EuroQoL 5-dimension (EQ-5D) index. In CC patients, cough-specific patient-reported outcomes (PROs) were additionally measured. Cross-sectional analyses were performed to evaluate demographic and clinical parameters associated with the EQ-5D index of CC patients.
Results: A total of 200 CC patients (137 newly referred with CC and 63 refractory or unexplained CC [RUCC] patients), 800 non-cough controls, and 799 healthy controls were analyzed. The EQ-5D index of CC patients was significantly lower than that of non-cough controls or healthy controls (0.82 ± 0.14 vs 0.92 ± 0.14/0.96 ± 0.08; P < 0.001, respectively). The index was also associated with older age (≥ 60 years), female sex, and comorbidities such as asthma or depression. Among the patients with CC, the index was significantly lower in patients with RUCC than in those with newly referred CC, being treated with codeine or cough neuromodulators, or with cough-related fatigue. In Spearman analyses, the EQ-5D index correlated with cough-specific quality of life and cough severity scores, not with throat sensation or cough trigger scores.
Conclusions: The HRQoL impairment of CC patients was associated with older age, female sex, and comorbidities but it was also affected by cough severity, complications, treatments, and treatment responses. Longitudinal studies are warranted to further understand and improve the HRQoL of CC patients.
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.
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