Materiały źródłowe

• #1 Long-term prognosis of chronic cough: a prospective, observational cohort study

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5697342/

  The long-term prognosis of chronic cough and its determinants need to be clarified. […] Almost half of subjects with chronic cough still suffer from the disorder at five years from initial assessment. […] Several possible determinants of poor prognosis could be identified. […] Continuing regular cough was associated with presence of chronic rhinitis or esophageal reflux disease, baseline mild airway responsiveness to histamine, and baseline strong cough responsiveness to hypertonic saline. […] Continuing impairment in cough-related quality of life was associated with high body mass index, absence of atopy, absence of pets, and high number of background disorders (esophageal reflux disease, asthma, or chronic rhinitis). […] The prognosis of chronic cough in the present study was slightly better than in the previous study about this issue.

• #2 Long-term prognosis of chronic cough: a prospective, observational cohort study | BMC Pulmonary Medicine | Full Text

  https://bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-017-0496-1

  The long-term prognosis of chronic cough and its determinants need to be clarified. […] At five years, continuing regular cough was present in 31 (46%) of the subjects and continuing impairment in cough-related quality of life (less than 1.3 points improvement in LCQ) in 32 (47%). […] Almost half of subjects with chronic cough still suffer from the disorder at five years from initial assessment. […] A subject can experience impaired cough-related QoL even if the cough is not regular anymore. […] Strong cough responsiveness to hypertonic aerosol may be an indicator of dysfunction of the cough reflex arch and poor prognosis. […] Finally, obesity seems to be strongly associated with poor prognosis in chronic cough and an intervention for weight loss is a promising therapeutic option to be evaluated in the future.

• #2 Long-term prognosis of chronic cough: a prospective, observational cohort study

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5697342/

  An increase in the number of background disorders (esophageal reflux disease, asthma, and rhinitis) was associated with both continuing regular cough and continuing impairment in cough-related QoL. […] Strong cough responsiveness to hypertonic aerosol may be an indicator of dysfunction of the cough reflex arch and poor prognosis. […] Finally, obesity seems to be strongly associated with poor prognosis in chronic cough and an intervention for weight loss is a promising therapeutic option to be evaluated in the future.

• #3 Chronic cough: new insights and future prospects

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9488126/

  Chronic cough is defined in adults as a cough that lasts for 8 weeks. When it proves intractable to standard-of-care treatment, it can be referred to as refractory chronic cough (RCC). Chronic cough is now understood to be a condition of neural dysregulation. Chronic cough and RCC result in a serious, often unrecognized, disease burden, which forms the focus of the current review. […] Chronic cough exerts a considerable burden on patients and healthcare systems. In addition to effective targeted therapies, further data are needed to understand the pathophysiology, epidemiology and disease burden. […] Chronic cough is associated with a serious disease burden and there is an unmet need for better treatments. […] CHS therefore represents a specific disease state that can be targeted by therapeutic interventions. In the context of chronic cough, therefore, CHS represents a significant treatment target.

• #4 Chronic cough: new insights and future prospects

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9488126/

  The development of new potential treatments for RCC, including the first-in-class P2X3 and P2X2/3 receptor antagonist gefapixant, as well as more the recently developed eliapixant, filapixant, BLU-5937, sivopixant and agents acting on other pathways, has provided new insights into the pathophysiology of RCC including the role of P2X3 receptors in humans. […] New treatments targeting underlying CHS are in advanced development, with the potential to reduce the enormous clinical and societal burden of RCC.

• #5 Causes and outcome in cough | Thorax

  https://thorax.bmj.com/content/64/Suppl_4/A15

  Patients with chronic obstructive pulmonary disease (COPD) complain of cough and mucus hypersecretion. […] Ambulatory objective monitoring provides novel insights into the relative effects of smoking and airflow obstruction on the symptom of cough. […] Higher cough rates indicate poor asthma control. Sputum eosinophils, 24 h cough rate and smoking history independently predict asthma control, and number of eosinophils corrected for sputum weight explains more of the variance in ACQ scores than percentage eosinophils. […] Cough improves over time in the majority of patients with unexplained chronic cough. However, patients have an increased rate of decline in FEV1 which is associated with a heightened cough reflex. […] Surgical treatment in refractory disabling cough is a valid option. Surgical treatment does have significant associated complications and patients should be carefully selected.

• #6 Seasonal variation of pediatric asthma exacerbations and its association with asthma phenotypes | Pediatric Research

  https://www.nature.com/articles/s41390-025-04073-2

  HBE/LBN phenotype had a higher risk of asthma exacerbations among hospitalized pediatric asthma patients in the winter and autumn, while LBE/LBN phenotype had a lower risk in the winter, spring, and summer. […] Blood eosinophils and neutrophils have been indicated to have a potential influence on pediatric asthma development and severity. […] HBE/LBN phenotype was associated with increased asthma exacerbations among hospitalized pediatric asthma patients during winter and autumn. […] Eosinophil and neutrophil predominance exhibited a higher influence on pediatric asthma exacerbations. […] We observed that asthma phenotypes were associated with an increase in asthma exacerbations in hospitalized pediatric asthma patients. […] Our study highlights that the HBE/LBN phenotype was associated with increased asthma exacerbations among hospitalized pediatric asthma patients during the winter and autumn seasons. Furthermore, eosinophil and neutrophil predominance exhibited a higher influence on pediatric asthma exacerbations before the COVID-19 pandemic. These findings underscore the potential of asthma blood inflammatory phenotypes in predicting asthma control and management in clinical practice.

• #7 Development of a prediction tool for patients presenting with acute cough in primary care: a prognostic study spanning six European countries | British Journal of General Practice

  https://bjgp.org/content/68/670/e342

  Accurate prediction of the course of an acute cough episode could curb antibiotic overprescribing, but is still a major challenge in primary care. […] The authors set out to develop a new prediction rule for poor outcome (re-consultation with new or worsened symptoms, or hospital admission) in adults presenting to primary care with acute cough. […] The new prediction rule, included the baseline Risk of poor outcome, Interference with daily activities, number of years stopped Smoking ( or 45 years), severity of Sputum, presence of Crackles, and diastolic blood pressure ( or 85 mmHg) (RISSC85). […] The new prediction rule outperforms all existing alternatives in predicting poor outcome in adult patients presenting to primary care with acute cough and could not be improved by including additional test results.

• #8 New tool better at predicting the prognosis of acute cough, study finds | Nursing in Practice

  https://www.nursinginpractice.com/latest-news/new-tool-better-at-predicting-the-prognosis-of-acute-cough-study-finds/

  A new tool for predicting the course of an acute cough in primary care could help reduce antibiotic prescriptions, researchers have found. […] The newly developed RISSC85 tool outperforms other tools for predicting the outcome of acute cough, which could be useful for helping to cut down on antibiotic prescribing, they claimed. […] Around 20% of these patients experienced a poor outcome, defined as re-consultation or hospital admission. […] They found that although the performance of RISSC85 was suboptimal, with a positive predictive value of 27%, it still performed better than existing prognostic prediction tools, such as the PSI and CRB65 tools, at separating patients who were and were not at risk of poor outcome. […] They authors also suggested that as the tool had a negative predictive value of 86%, it could be useful for reassuring patients that their cough was not clinically significant and for reducing antibiotic prescriptions.

• #9 Development of a prediction tool for patients presenting with acute cough in primary care: a prognostic study spanning six European countries | British Journal of General Practice

  https://bjgp.org/content/68/670/e342

  In adults presenting to primary care with acute cough, accurate prediction of poor outcome could curb antibiotic overprescribing. […] The performance of existing prediction rules to predict poor outcome in these patients is very poor. […] The new prediction rule, RISSC85, presented in this study outperforms these alternatives, and could not be improved by including additional test results. […] The prediction rule can, however, still be used in other countries, by estimating their baseline risk for poor outcome using literature or personal experience, after which the country can be classified into group A, B, or C. […] Although the predictive ability of RISSC85 is suboptimal, it is the best currently available option to predict poor outcome in adult patients presenting to primary care with acute cough.

• #10 New tool better at predicting the prognosis of acute cough, study finds | Nursing in Practice

  https://www.nursinginpractice.com/latest-news/new-tool-better-at-predicting-the-prognosis-of-acute-cough-study-finds/

  They said in the paper that practice nurses and GPs could use the simplified RISSC85 to differentiate between patients where a wait and see approach is appropriate, and careful reassurance is the preferred treatment strategy, and those more at risk for poor outcome, who could then be more explicitly advised about key symptoms and signs that require re-consultation, and possibly offered a delayed prescription.

• #11 Clinical Significance of Cough Peak Flow and Its Non-Contact Measurement via Cough Sounds: A Narrative Review

  https://www.mdpi.com/2076-3417/10/8/2782

  Coughing is the primary defence mechanism against foreign bodies in the central airways and can quantitatively be assessed by cough peak flow (CPF). […] This review regards the method for measurement of CPF, the cough-related factors influencing CPF, the clinical significance of CPF evaluation, and a novel cough strength prediction method using cough sounds. […] Furthermore, this review presents various cutoff thresholds that predict extubation failure in patients on mechanical ventilation, acute respiratory failure, and aspiration risk. […] The published clinical evidence of CPF demonstrates reasonable diagnostic accuracy, predictive power, and validity, although additional studies on the non-contact measurement of CPF via cough sounds with better-quality methodologies are required.

• #12 Clinical Significance of Cough Peak Flow and Its Non-Contact Measurement via Cough Sounds: A Narrative Review

  https://www.mdpi.com/2076-3417/10/8/2782

  In addition, a recent study involving thirty-four patients with amyotrophic lateral sclerosis reported that the CPF decline rate reflects the progression of bulbar and respiratory dysfunction and is an independent prognostic factor for survival as, patients exhibiting a CPF decline rate over 25% had a shorter overall survival (p < 0.0001). [...] Moreover, in adults and probably also children above 12 years of age, a CPF above 160 L/min is required to effectively clear secretions and maintain airway patency because patients with an assisted CPF under 160 L/min cannot be successfully extubated or decannulated. [...] The application of positive pressure with a self-inflating bag and mask, an intermittent positive pressure breathing device, and a mechanical ventilator are effective techniques to increase the MIC. [...] CPF was used as a predictor of extubation failure in patients on mechanical ventilation, acute respiratory failure, and aspiration.

• #13 Utilization of spontaneous breathing trial, objective cough test, and diaphragmatic ultrasound results to predict extubation success: COBRE-US trial | Critical Care | Full Text

  https://ccforum.biomedcentral.com/articles/10.1186/s13054-023-04708-y

  The results of clinical and weaning readiness tests and the spontaneous breathing trial (SBT) are used to predict the success of the weaning process and extubation. […] To predict extubation success, we derived the following equation: (5.7SBT)+(0.75Cough)(0.25DCV)4.5. When the cutoff point was1.25, the sensitivity was 96.8%, the specificity was 78.4%, and the overall accuracy was 91.5%. The AUC-ROC of this model was 0.91. […] Objective measurement of cough and diaphragmatic contraction velocity could be used to predict SBT success. The equation for predicting successful extubation, which includes SBT, cough, and diaphragmatic contraction velocity values, showed excellent discriminative capacity. […] We found a significant association between SBT success and the objective measurement of cough (p=0.02), DCV (p=0.01), and the duration of the diaphragmatic cycle (p=0.008).

• #14 Utilization of spontaneous breathing trial, objective cough test, and diaphragmatic ultrasound results to predict extubation success: COBRE-US trial | Critical Care | Full Text

  https://ccforum.biomedcentral.com/articles/10.1186/s13054-023-04708-y

  The multivariate logistic regression model for predicting SE that incorporates these variables showed excellent discriminatory capacity. […] Our findings indicate that when cough and diaphragmatic contraction velocity are objectively measured, the values can be used to predict whether an SBT will be successful or not. In addition, we have formulated an equation using SBT, cough test, and diaphragmatic contraction velocity values that shows excellent discriminative capacity in terms of predicting SE.

• #15 Challenges and Opportunities of Deep Learning for Cough-Based COVID-19 Diagnosis: A Scoping Review

  https://www.mdpi.com/2075-4418/12/9/2142

  In the past two years, medical researchers and data scientists worldwide have focused their efforts on containing the pandemic of coronavirus disease 2019 (COVID-19). Deep learning models have been proven to be capable of efficient medical diagnosis and prognosis in cancer, common lung diseases, and COVID-19. […] This literature review aims to report the state of research on developing neural network models to diagnose COVID-19 from cough sounds to create a cost-efficient and accessible testing tool in the fight against the pandemic. […] We found that cough is a biomarker, and its associated information can determine an individual’s health status. […] In sum, the total or phase duration, peak frequency, location, intensity, pattern, energy spectrum, and power ratio can help distinguish between healthy and COVID-19-positive patients. […] We conclude that cough sounds can be used as biomarkers for identifying coronavirus and respiratory diseases and can be complemented by breath and speech sounds to improve detection accuracy.

• #16 Chronic cough and a normal chest X-ray – a simple systematic approach to exclude common causes before referral to secondary care: a retrospective cohort study | npj Primary Care Respiratory Medicine

  https://www.nature.com/articles/npjpcrm201581

  Chronic cough is common in the community and can cause significant morbidity. […] We aimed to assess the management of chronic cough in primary care before referral to a cough clinic, and to assess the outcome of managing chronic cough with an approach of simple investigation and empirical treatment trials. […] Most cases of chronic cough referred to secondary care could be managed with a simple and systematic approach, which is potentially transferrable to a community setting. […] The aims of the current study were to review general practice management of chronic cough in patients later referred to secondary care, and to describe outcomes (final diagnoses and resolution of symptoms) from managing chronic cough with an approach based on simple investigation and empirical treatment trials in a district general hospital.

• #17 Chronic cough and a normal chest X-ray – a simple systematic approach to exclude common causes before referral to secondary care: a retrospective cohort study | npj Primary Care Respiratory Medicine

  https://www.nature.com/articles/npjpcrm201581

  We demonstrated good patient outcomes in a secondary-care cough clinic over a median of only two clinic visits. […] The majority (80%) of cases of chronic cough referred from primary to secondary care could therefore be managed in a systematic and simple way. […] Our findings are consistent with other reports from the United Kingdom, which indicate that referrals to secondary care for chronic cough are often premature. […] We estimated that unexplained cough and rhinosinusitis would be the most common diagnoses among GP referrals if a simple management algorithm had already been followed. […] Fewer patients with chronic cough could be referred to secondary care. The majority of patients in our clinic were managed successfully with a simple and systematic approach adaptable to general practice.

Zobacz więcej