A novel diagnostic algorithm for chronic and subacute cough

Peng Lu; Dan Zhou; Chengzhen Jin

doi:10.4081/mrm.2014.401

A novel diagnostic algorithm for chronic and subacute cough

Authors

Peng Lu Respiratory Department, Second Affiliated Hospital of Harbin Medical University, Harbin
Dan Zhou Respiratory Department, Second Affiliated Hospital of Harbin Medical University, Harbin
Chengzhen Jin Respiratory Department, Fourth Affiliated Hospital of Harbin Medical University, Nangang District, Harbin

DOI: https://doi.org/10.4081/mrm.2014.401

Keywords:

Asthma, Cough, Diagnosis, Gastroesophageal reflux disease, Postnasal drip syndrome

Abstract

Background: Cough remains the most common reason for patients to seek medical attention. We practised a novel diagnostic algorithm for chronic and subacute cough.

Methods: Chronic and subacute cough patients with normal chest X-ray results and without respiratory tract infections in the preceding eight weeks were recruited. The patients were divided into two groups: Group A, patients with typical symptoms and signs of postnasal drip syndrome (PNDS), asthma syndromes (AS) and gastroesophageal reflux disease (GERD); Group B, patients without the typical symptoms and signs. The two groups received targeted or sequential empirical trials of therapy according to the algorithm.

Results: Among the 524 patients available for analysis in Groups A and B, 436 (83.6%) were diagnosed to have PNDS (34.2%), AS (44.5%) and/or GERD (10.1%), among which 26 had two causes (6.0%) and 6 had three causes (1.4%). After empirical trials of therapy, 81.5% of the patients were diagnosed. The mean time for diagnosis was considerably shorter in Group A (13.1 ± 5.6 d) than in Group B (23.4 ± 7.2 d) (p < 0.01). The diagnosis rate of the first trial in Group A (54.1%) was significantly higher than that in Group B (28.6%, p < 0.01).

Conclusions: The proposed algorithm is a promising and practical approach to diagnose chronic and subacute cough.