A multicenter study on chronic cough in children : burden and etiologies based on a standardized management pathway

Chang, Anne B., Robertson, Colin F., van Asperen, Peter P., Glasgow, Nicholas J., Mellis, Craig M., Masters, I. Brent, Teoh, Laurel, Tjhung, Irene, Morris, Peter S., Petsky, Helen L., Willis, Carol, & Landau, Lou I. (2012) A multicenter study on chronic cough in children : burden and etiologies based on a standardized management pathway. Chest, 142(4), pp. 943-950.

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Abstract

Background

While the burden of chronic cough in children has been documented, etiologic factors across multiple settings and age have not been described. In children with chronic cough, we aimed (1) to evaluate the burden and etiologies using a standard management pathway in various settings, and (2) to determine the influence of age and setting on disease burden and etiologies and etiology on disease burden. We hypothesized that the etiology, but not the burden, of chronic cough in children is dependent on the clinical setting and age.

Methods

From five major hospitals and three rural-remote clinics, 346 children (mean age 4.5 years) newly referred with chronic cough (> 4 weeks) were prospectively managed in accordance with an evidence-based cough algorithm. We used a priori definitions, timeframes, and validated outcome measures (parent-proxy cough-specific quality of life [PC-QOL], a generic QOL [pediatric quality of life (PedsQL)], and cough diary).

Results

The burden of chronic cough (PC-QOL, cough duration) significantly differed between settings (P = .014, 0.021, respectively), but was not influenced by age or etiology. PC-QOL and PedsQL did not correlate with age. The frequency of etiologies was significantly different in dissimilar settings (P = .0001); 17.6% of children had a serious underlying diagnosis (bronchiectasis, aspiration, cystic fibrosis). Except for protracted bacterial bronchitis, the frequency of other common diagnoses (asthma, bronchiectasis, resolved without specific-diagnosis) was similar across age categories.

Conclusions

The high burden of cough is independent of children’s age and etiology but dependent on clinical setting. Irrespective of setting and age, children with chronic cough should be carefully evaluated and child-specific evidence-based algorithms used.

Impact and interest:

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ID Code: 75747
Item Type: Journal Article
Refereed: Yes
Keywords: Clinical-Practice Guidelines, Quality-of-Life, Protracted Bacterial Bronchitis, Pediatric Chronic Cough, Generic Core Scales, Chronic Wet Cough, Persistent Cough, Young-Children, Lung-Disease, Asthma
DOI: 10.1378/chest.11-2725
ISSN: 0012-3692
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PAEDIATRICS AND REPRODUCTIVE MEDICINE (111400) > Paediatrics (111403)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Public Health & Social Work
Funding:
Deposited On: 29 Aug 2014 01:34
Last Modified: 29 Jan 2015 00:10

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