Chronic cough with limited response to treatment and incidence of gastroesophageal reflux

Abstract

Our objective was to evaluate the association between chronic cough and the variables that could influence the course of the cough in order to develop a profile for coughers with poor response to treatment. In our Chronic Cough Unit, 192 patients were prospectively followed up for 3 months, during which time all the variables that could influence the cough reflex were evaluated and treated. The improvement in cough was evaluated by the response of the patients to a visual analogical scale with scores from 0 to 4, considering 0 as «no changes» and an improvement as a score of 3 or 4. The cough was considered to have little response to treatment if it persisted without any improvement for more than 3 months. Using a multivariate logistic regression model, we input variables that were candidates for being associated with the improvement in cough 3 months later. In the final profile model of the cougher with poor prognosis, three variables remained: sex, typical gastroesophageal reflux and psychosocial disorder. Being male is associated with an improvement in cough 3 months later (OR=2.10, 95%CI 1.00-4.38). However, having gastroesophageal reflux is associated with a reduction in the improvement three months later in 55% (OR=0.45, 95%CI 0.24-0.84), and having a psychosocial disorder reduces the probability for improvement of the cough 3 months later in 70% (OR=0.30, 95%CI 0.09-1.03).