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Risk factors for persistent chronic cough during consecutive years

Published: March 8, 2022

Persistent chronic cough (PCC) is a condition with high clinical burden and limited knowledge of the risk factors that drive the persistent symptoms. In a retrospective study published recently in The Journal of Allergy and Clinical Immunology: In Practice, Dr. Robert S. Zeiger and colleagues determined the risk factors in adults aged 18-85 years associated with PCC in chronic cough patients diagnosed by a specialist (pulmonologist, allergist, otolaryngologist, or gastroenterologist) in 2011-2016. PCC was defined by another chronic cough code or at least 2 cough events at least 8 weeks but no more than 4 months apart in each of the 2 consecutive years beginning 1-year after the original chronic cough diagnosis. Unadjusted and adjusted risk ratios (RR) with 95% confidence intervals (CI) for patient characteristics at baseline in relationship to PCC were estimated by Poisson regression models with robust error variance.

Of the adults with chronic cough, 3,270 (27.4%) had PCC and 5,302 (44.5%) didn’t have chronic cough during follow-up; 3341 (28.1%) had chronic cough in only one follow-up year and were excluded from the analysis. Compared to non-PCC patients, patients with PCC were noted to have significantly increased adjusted risk ratios for the following baseline features: (1)  demographics: (elderly, females, and less educated,); (2) comorbidities (COPD, chronic sinusitis, bronchiectasis, pulmonary fibrosis, hypertension, depression, and cough complications); (3) medication dispensed (inhaled corticosteroid/long-acting beta-agonists, leukotriene modifiers, nasal corticosteroids, nasal short acting-muscarinic antagonists, proton pump inhibitors, antitussives with narcotics, and neuromodulators; and (4) specialist care, particularly with pulmonologists.

Knowing the independent risk factors associated with PCC should aid clinicians in identifying such patients and improve their management.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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