Kronik Öksürük; Tanı ve Tedavi Pratiği

Abstract

Yesilyurt S. Chronic Cough: Clinical and Treatment Practice Features, Hacettepe University Faculty of Medicine, Department of Chest Diseases, Ankara, 2022.

Background: A chronic cough is defined as a cough that lasts longer than 8 weeks. Epidemiological studies on chronic cough are mostly western-centered, and studies on this subject are very limited in our country. The aim of this study is to examine the clinical and etiological features of chronic cough in adult patients and to develop an algorithm that includes practical treatment approaches.

Materials and Methods: A total of 224 patients aged 18 years and older who applied to our center due to chronic cough between January 2019 and September 2021 were included in the study. Demographic, clinical and laboratory data of the patients were obtained from the hospital electronic database and analyzed retrospectively. The clinical and etiological features of chronic cough and related parameters were revealed. The factors that may be related to the treatment response were investigated by statistical methods by examining the exact diagnosis information and treatment practices.

Results: The mean age of 224 patients [166 (74.1%) female, 58 (25.9%) male] included in the study was 46.2±17 years. The 3 most common chronic cough etiologies were postinfectious cough (22.3%), allergic rhinitis (19.6%) and allergic asthma (18.8%). While a single etiology was detected in 124 (55.4%) patients, more than one cause was shown in 100 (44.6%) patients. The most common treatments in our hospital were ICS (66.5%), nasal steroids (60.3%), montelukast (60.3%), oral steroids (30.4%)(It was noted that corticosteroid treatments were administered between 7 and 21 days in the patient cohort) and antihistamine agents (23.7%). Treatment response was shown to be significantly higher in patients with asthma (21.4% vs. 0% p=0.007). In addition, it was found that the use of antihistamine agents (p=0.007) and weight loss (p=0.04) were associated with high response rates. Anamnestic BHR was higher in women. Total IgE and eosinophil levels were found to be inversely proportional to age (p=0.007). As the duration of use increased in smokers, treatment response rates decreased significantly (p=0.002).

Conclusion: Chronic cough is a condition that affects the quality of life of patients and causes heavy loss of work force and financial burden. When detailed anamnesis is taken from the patients and appropriate tests are performed, the cause can be found in most of them and cause spesific treatment can be given. Our study effectively demonstrates that the most common causes of chronic cough among patients admitted to the Hacettepe Hospital Chest Diseases Department and Allergy and Immunology Department. and which treatments are effective. Together with the results of this study, it will be possible for the patients to be treated at the first examination without the need to apply to more than one center. This is the first study investigating chronic cough in adults in Turkey.