Changing etiological frequency of chronic cough in a tertiary hospital in Shanghai, China

Hongmei Ding; Xianghuai Xu; Siwan Wen; Yiming Yu; Jing Pan; Cuiqin Shi; Ran Dong; Zhongmin Qiu; Li Yu

doi:10.21037/jtd.2019.07.86

Changing etiological frequency of chronic cough in a tertiary hospital in Shanghai, China

J Thorac Dis. 2019 Aug;11(8):3482-3489. doi: 10.21037/jtd.2019.07.86.

Authors

Hongmei Ding^{1

2}, Xianghuai Xu¹, Siwan Wen¹, Yiming Yu³, Jing Pan³, Cuiqin Shi¹, Ran Dong¹, Zhongmin Qiu¹, Li Yu¹

Affiliations

¹ Department of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China.
² Department of Pulmonary and Critical Care Medicine, Shanghai Putuo District People's Hospital, Shanghai 200060, China.
³ Department of Respiratory Medicine, Tongren Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200336, China.

Abstract

Background: The frequency distributions of the etiologies of chronic cough have changed over time. This study aimed to investigate the changing etiological frequency of chronic cough in a tertiary hospital in Shanghai, China, and to explore the clinical significance.

Methods: Medical records of 1,311 patients with chronic cough who visit our hospital between January 2009 and December 2016 were retrospectively reviewed. The etiologies of chronic cough were identified according to a standardized step-by-step diagnostic protocol and the changes in the etiological frequency of chronic cough over the years were using the Chi-squared (χ²) test.

Results: Cough variant asthma (CVA) (449/1,311, 34.2%), gastroesophageal reflux-related chronic cough (GERC) (374/1,311, 28.5%), upper airway cough syndrome/postnasal drip syndrome (UACS/PNDs) (241/1,311, 18.4%), atopic cough (AC) (188/1,311, 14.3%), and non-asthmatic eosinophilic bronchitis (NAEB) (147/1,311, 11.2%) were the common causes of chronic cough in descending order. The post-infectious cough (PIC) (39/1,311, 3.0%) and angiotensin-converting enzyme inhibitor (ACEI)-induced cough (25/1,311, 1.9%) were less common. During the 8-year period, the proportion of CVA (χ²=72.86, P<0.0001) and UACS/PNDs (χ²=68.80, P<0.0001) decreased, while those of NAEB (χ²=51.38, P<0.0001), GERC (χ²=55.95, P<0.0001) and AC (χ²=39.09, P<0.0001) increased.

Conclusions: The etiological frequency of chronic cough varies over time, and it may encourage the adjustment of the current diagnostic and therapeutic strategies for chronic cough.

Keywords: Chronic cough; atopic cough (AC); cough variant asthma (CVA); gastroesophageal reflux-related chronic cough (GERC); non-asthmatic eosinophilic bronchitis (NAEB); upper airway cough syndrome/postnasal drip syndrome.