S29 Cough frequency and morbidity in inpatients with acute respiratory disease

RD Turner, SS Birring, S Matos, GH Bothamley
2013 Thorax  
Introduction Cough is the unique respiratory symptom. Although associated with a range of conditions it has been little studied in acute respiratory disease. We describe cough frequency and cough-related quality of life in this group. Method Participants had a diagnosis of acute exacerbation of asthma (asthma), chronic obstructive pulmonary disease (AECOPD), or lower respiratory tract infection (including community-acquired pneumonia) in the absence of the other respiratory disease (LRTI).
more » ... isease (LRTI). Quality of life was measured with the Leicester Cough Questionnaire (LCQ-acute), cough severity with a visual analogue scale (VAS) and 24-hour cough frequency with the Leicester Cough Monitor. Results 40 patients were recruited within a median (interquartile range) of 1 (1-2.3) day ( ) of hospital admission. Median (IQR) age was 57 (41-71) and 63% were female. Geometric mean ± log 10 SD cough frequencywas high: 19.7 ± 1.36, 33.8 ± 2.02 and 23.6 ± 1.31 coughs/h for asthma (n = 11), AECOPD (n = 15) and LRTI (n = 14) respectively ( Figure) ; median (IQR) cough bouts/24h: 81 (54-210), 148 (97-197) and 129 (67-197). There was no significant difference between disease groups in these values (p > 0.05 for all two-way comparisons). Diurnal variation and median numbers of coughs/ bout were similar between groups. The 48% of patients who were current smokers coughed more than non-smokers (33.6 ± 1.91 vs 20.2 ± 1.38 coughs/h, p = 0.07). No difference in cough frequency was detected amongst the 25% taking angiotensin converting enzyme inhibitors. Gender had no significant overall effect. Median (IQR) VAS scores were 39 (32-86), 73 (53-100) and 82 (48-91) for asthma, AECOPD and LRTI respectively with no significant difference between them. Cough severity showed a significant correlation with 24-hour cough frequency overall (Spearman' coefficient 0.33, p = 0.05). LCQ-acute scores were lower for LRTI (8.4; 6.4-9.5) than asthma (14.7; 10.7-17.5); p = 0.01 (Figure 1) . Neither was significantly different from those for AECOPD (11.5; 8.5-15.6). Quality of life did not correlate with cough frequency (Spearman' coefficient -0.13; p = 0.48). Conclusion Cough frequency in acute respiratory disease is high but with high variation. Cough frequency accounts for only part of morbidity in these conditions.
doi:10.1136/thoraxjnl-2013-204457.36 fatcat:auekomwgyfgorbfyh7jwhwrqnu