Point prevalence and epidemiological characteristics of chronic cough in the general adult population

Abstract

Cough is frequently self-limiting, but may persist longer in certain individuals. Most of previous studies on the epidemiology of chronic cough have only measured period prevalence, and thus have afforded limited information on the burden and natural course. We aimed to investigate the epidemiology of chronic cough by using a point prevalence measure in a large-scale general population.We analyzed cross-sectional data collected from 18,071 adults who participated in the Korean National Health and Nutrition Examination Survey 2010–2012. Presence and duration of current cough was ascertained by structured questionnaires, and cough was classified into acute (<3 weeks), subacute (3–8 weeks), or chronic cough (≥8 weeks). Demographic and clinical parameters were examined in relation to chronic cough.The point prevalences of acute, subacute, and chronic cough were 2.5 ± 0.2%, 0.8 ± 0.1% and 2.6 ± 0.2%, respectively. The proportion of current cough showed a steep decrease after 1 week of duration. However, 2 peaks in the prevalence of current cough were revealed; cough durations of less than 1 week and longer than 1 year were most common (31.1% and 27.7% of current cough, respectively). Subacute and chronic cough were more prevalent in the elderly (≥65 years); the positive associations with older age were independent of other confounders, including current smoking and comorbidities.This is the first report on the epidemiology of cough using a point prevalence measure in a nationally representative population sample. Our findings indicate a high burden of chronic cough among adults with current cough in the community. The dual-peak of cough duration suggested that the pathophysiology of acute and chronic cough may differ. The preponderance of elderly people in the prevalence of chronic cough warrants further investigation. In addition, more sophistication and validation of tools to define chronic cough will help our understanding of the epidemiology.

Factors Associated with Increased Healing Time in Complete Femoral Fractures After Long-Term Bisphosphonate Therapy

“…We identified a difference in the duration of bisphosphonate use between the successful healing and problematic healing groups. A longer duration of bisphosphonate use was significantly associated with a higher rate of problematic healing, which is consistent with the results of other studies 17,23 . Prodromal symptoms can serve as an indicator of impending fracture associated with long-term use of bisphosphonates 24 .…”

“…A lthough atypical femoral fractures have been reported to be at risk of failure of healing 12,[15][16][17]19 , few studies have analyzed factors affecting healing time in long-term bisphosphonate users. The present study sought to determine factors predictive of delayed union or nonunion in a consecutive series of 109 complete femoral fractures associated with long-term use of bisphosphonates.…”

“…Several recent studies have addressed the operative treatment, complications, and healing rates of atypical femoral fractures [11][12][13][14][15][16] . Although the precise prognosis is still unknown, there is a growing consensus that the altered bone metabolism caused by long-term use of bisphosphonates would adversely affect bonehealing even after osteosynthesis 12,15,17 . Delayed or failed fracturehealing is becoming a major concern after fracture stabilization in patients taking bisphosphonates 13 .…”

ERS guidelines on the diagnosis and treatment of chronic cough in adults and children

“…It was more prevalent in Europe, America and Oceania than in Asia and Africa. Notably, the prevalence of chronic cough in adults is associated with a number of characteristics [13][14][15][16]. In a recent international survey of 10 032 adult patients attending specialist cough clinics, two-thirds were female and the most common age for presentation was in the sixth decade [3].…”

Prevalence and incidence of, and risk factors for chronic cough in the adult population: the Rotterdam Study

“…We observed that the prevalence of chronic cough increased with age and that chronic cough was more prevalent in subjects aged 70 years and above. Likewise, the results of the Korean National Health and Nutrition Examination Survey showed that chronic cough was more prevalent in elderly subjects [28].…”