What type of study is this?

This is a Cross-Sectional Study study (also classified as: Quantitative Study).

September 18, 2025Open Access

Multicenter questionnaire study investigating characteristics of adults with unexplained chronic cough versus explained chronic cough

Key Points

Patients with unexplained chronic cough showed specific demographic features and environmental sensitivities, indicating clear differentiation from explained chronic cough.
Key factors like the absence of postnasal drip, comorbid conditions, and higher cough severity significantly differentiated chronic cough types.
The study involved 150 patients, with 29 having unexplained chronic cough, analyzed through logistic regression and univariate comparisons.
Identifying these risk factors could accelerate the diagnosis of unexplained chronic cough, enhancing patient management strategies.

Abstract

Objective: Previously, we reported that older women taking increased numbers of cough medications with increased number and frequency of medical encounters and normal or near-normal lung function more likely had unexplained chronic cough (UCC) versus asthma and/or chronic obstructive pulmonary disease. This study sought to identify clinical risk factors that could differentiate UCC from explained chronic cough (ECC). Methods: A validated electronic questionnaire was distributed to patients with chronic cough (CC) at seven cough centers throughout the United States. The mean ± standard error, frequencies of continuous variables (one-way analysis), and cross-tabulation frequencies for categorical variables (two-way analysis) were calculated. Univariate comparisons between UCC and ECC were performed by using the t-test and nonparametric one-way analysis. Significant determinants of UCC and cough severity were assessed by using multiple logistic regression. Results: A total of 150 patients were enrolled, of whom 29 of 150 were classified as having UCC, and 121 of 150 were classified as having ECC. No significant differences for family history, age, gender, and race, or seasonality differentiated UCC from ECC. Multiple logistic regression revealed the absence of postnasal drip significantly differentiated UCC from ECC (odds ratio 4.8 95% Confidence Level, 1.6‐15.3). The severity of CC was worse for patients with UCC, patients with chronic bronchitis and/or emphysema, hypertension, ex-smoking history, high body mass index, female gender, education level, and reactivity to more environmental irritants (perfume, p = 0.006; household cleaners, p = 0.01; air fresheners, p = 0.03; cold air, p = 0.007; cigarette smoke, p = 0.05). Conclusion: Patients with UCC more frequently presented with specific demographic features, comorbid characteristics, and more severe cough induced by environmental irritants compared with ECC. These clinical characteristics may be useful for identifying risk factors that can accelerate the diagnosis of UCC.

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