The demographic and clinical characteristics of an Italian population of adult outpatients with chronic cough
Chronic cough is a major health problem worldwide and patients are best managed in specialised tertiary centres. Little information is available on the characteristics of chronic cough patients in several European countries, including Italy.
We report on the demographic, anthropometric and clinical features of a large Italian population of adult chronic cough outpatients (about 1200), who were referred to a specialised clinic in Florence, Italy, from 2008 to 2018.
Demographic, environmental, lifestyle and clinical information was collected at enrolment by means of a custom-designed electronic questionnaire that only allowed for uniform responses. A subjective measure of cough-related discomfort (cough score) was also obtained using a modified Borg Scale. A multivariable logistic regression model was defined to identify the patients’ characteristics associated with the cough score.
The characteristics of the examined population (n = 1204 outpatients) were strikingly similar to those described elsewhere. Female patients outnumbered the males [n = 847 females, (70.0%)]; both females and males displayed the same average cough score. The median age of outpatients was 61 (quartile 1 = 48; quartile 3 = 70) years; age and cough duration were unrelated to the cough score. Nasal obstruction, coughing during consultation, coughing during meals, throat clearing and the presence of respiratory abnormalities were correlated with the degree of discomfort caused by coughing.
The features of chronic cough patients are similar worldwide. The process of cough reflex hypersensitisation may soothe sex-related perceptual differences, leading to similar levels of discomfort.
There seem to be clinical indicators that help in assessing the level of cough-related discomfort.
KeywordsChronic cough Cough score Cough-related discomfort
This work was funded by an unrestricted grant from Merck. We wish to thank all those physicians and post-graduate students who participated in the data collection throughout the years.
GC, FL, AF and GAF conceived and designed the study, interpreted the data and drafted the manuscript, which was critically revised by all authors. SM and MN analysed the data. All authors had access to the complete study data and had a say in the manuscript preparation, approval of the final version and the decision to submit for publication. GAF is the guarantor.
Compliance with ethical standards
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee (Ethics Committee of the Azienda Ospedaliero-Universitaria Careggi, Florence, Italy; OSS_14131) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
All the participants signed an informed consent form.