Objective measurement of cough during pulmonary exacerbations in adults with cystic fibrosis

Jaclyn A Smith ^1*, Emily C Owen ¹, Andrew M Jones ², Mary E Dodd ², A Kevin Webb ² and Ashley A Woodcock ¹

¹ South Manchester University Hospitals Trust, United Kingdom
² Manchester Adult Cystic Fibrosis Centre, United Kingdom

^* To whom correspondence should be addressed. E-mail: jackyannsmith{at}hotmail.com.

Accepted 24 January 2006

Abstract

Background: Little is known about cough frequency in adults with cystic fibrosis (CF). This study aimed to determine 1) daytime and overnight cough rates in patients with CF at the beginning and end of a course of antibiotics for treatment of an exacerbation; 2) the relationship between cough frequencies and standard clinical measures of disease; 3) the relationship between objective cough rates and the subjective assessment of cough.

Methods: 19 adult patients admitted with a pulmonary exacerbation performed daytime and overnight sound recordings on admission; 13 had repeat recordings prior to discharge. Coughs were manually quantified in cough seconds (time spent coughing). Patients subjectively scored their cough using a visual analogue scale (VAS) and numerical score. Lung function, C-reactive protein levels (CRP) and sputum weights were recorded.

Results: Cough rates fell substantially with treatment; median fall in cough rate was 51.3% (IQR 32.3-77.5) (p=<0.001) for daytime and 72.2% (28.6-90.1) (p=0.049) for overnight. Multivariate regression analyses examined the influence of lung function, sputum volume and CRP on cough rates. On admission, FEV1 and CRP predicted overnight cough rates. On discharge, sputum volume predicted daytime cough rates. Only the change in overnight VAS correlated with the change in objective cough rates.

Conclusions: Cough rate significantly decreased with treatment of a pulmonary exacerbation in adults with CF. Lung function, sputum volume and CRP influenced cough rates; the effects differed from day to night and between admission and discharge. Subjective reporting of a nocturnal cough may indicate a pulmonary exacerbation of CF in adults.

Keywords: cough monitor, respiratory infection, sputum

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Article

Airwaves

Wisia Wedzicha
Thorax 2006 61: 367. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

• Kelsall, A, Decalmer, S, McGuinness, K, Woodcock, A, Smith, J A (2009). Sex differences and predictors of objective cough frequency in chronic cough. Thorax 64: 393-398 [Abstract] [Full Text]  
• Kelsall, A., Decalmer, S., Webster, D., Brown, N., McGuinness, K., Woodcock, A., Smith, J. (2008). How to quantify coughing: correlations with quality of life in chronic cough. Eur Respir J 32: 175-179 [Abstract] [Full Text]  
• Morice, A. H., Fontana, G. A., Belvisi, M. G., Birring, S. S., Chung, K. F., Dicpinigaitis, P. V., Kastelik, J. A., McGarvey, L. P., Smith, J. A., Tatar, M., Widdicombe, J. (2007). ERS guidelines on the assessment of cough. Eur Respir J 29: 1256-1276 [Full Text]  
• Goss, C. H, Burns, J. L (2007). Exacerbations in cystic fibrosis {middle dot} 1: Epidemiology and pathogenesis. Thorax 62: 360-367 [Abstract] [Full Text]  
• Clare Decalmer, S., Webster, D., Alice Kelsall, A., McGuinness, K., Arthur Woodcock, A., Ann Smith, J. (2007). Chronic cough: how do cough reflex sensitivity and subjective assessments correlate with objective cough counts during ambulatory monitoring?. Thorax 62: 329-334 [Abstract] [Full Text]  
• Smith, J., Owen, E., Earis, J., Woodcock, A. (2006). Cough in COPD: Correlation of Objective Monitoring With Cough Challenge and Subjective Assessments.. Chest 130: 379-385 [Abstract] [Full Text]