0
Original Research: Signs and Symptoms of Chest Diseases |

A Multicenter Study on Chronic Cough in ChildrenMulticenter Cough Etiology: Burden and Etiologies Based on a Standardized Management Pathway

Anne B. Chang, PhD; Colin F. Robertson, MD; Peter P. Van Asperen, MD; Nicholas J. Glasgow, MD; Craig M. Mellis, MD; I. Brent Masters, PhD; Laurel Teoh, MD; Irene Tjhung, MBBS; Peter S. Morris, PhD; Helen L. Petsky, BNursing; Carol Willis; Lou I. Landau, MD
Author and Funding Information

From the Child Health Division (Drs Chang, Teoh, Tjhung, and Morris), Menzies School of Health Research, Charles Darwin University, Darwin, NT; Queensland Children’s Respiratory Centre (Drs Chang and Masters and Mss Petsky and Willis), Queensland Children’s Medical Research Institute, Royal Children’s Hospital, Brisbane, QLD; Department of Respiratory Medicine (Dr Robertson), Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, VIC; Department of Respiratory Medicine (Dr Van Asperen), Children’s Hospital at Westmead, Sydney Children’s Hospitals Network, University of Sydney, Sydney, NSW; Medical School (Dr Glasgow), Australian National University, Canberra, ACT; Central Clinical School (Dr Mellis), University of Sydney, Sydney, NSW; The Canberra Hospital (Dr Teoh), Canberra, ACT; Thursday Island Primary Health Care (Dr Tjhung), Thursday Island, QLD; NT Clinical School (Dr Morris), Flinders University, Darwin, NT; and Postgraduate Medical Council of Western Australia (Dr Landau), Health Department of Western Australia, Perth, WA, Australia.

Correspondence to: Anne B. Chang, PhD, Queensland Children’s Respiratory Centre, Royal Children’s Hospital, Herston, QLD, 4029, Australia; e-mail: annechang@ausdoctors.net


Funding/Support: This study is funded by an Australian National Health and Medical Research Council (NHMRC) project grant [490321]. Dr Chang is supported by a NHMRC fellowship [545216].

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2012;142(4):943-950. doi:10.1378/chest.11-2725
Text Size: A A A
Published online

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.

Trial registry:  Australian New Zealand Clinical Trials registry; No.: ACTRN12607000526471; URL: www.anzctr.org.au

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543