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Higher cough flow is associated with lower risk of pneumonia in acute stroke
  1. Stefan T Kulnik1,
  2. Surinder S Birring2,
  3. John Hodsoll3,
  4. John Moxham2,
  5. Gerrard F Rafferty2,
  6. Lalit Kalra4
  1. 1Faculty of Health, Social Care and Education, St George's, University of London, London, UK
  2. 2Division of Asthma, Allergy & Lung Biology, Faculty of Life Sciences and Medicine, King's College London, London, UK
  3. 3Department of Biostatistics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
  4. 4Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
  1. Correspondence to Dr Stefan T Kulnik, Faculty of Health, Social Care and Education, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK; stefan.kulnik{at}nhs.net

Abstract

There is little available evidence to demonstrate how cough strength mediates the risk of aspiration-related pneumonia in acute stroke. Our secondary analysis of trial data indicates that risk of pneumonia reduces with increasing peak cough flow (PCF) of voluntary cough (OR 0.994 for each 1 L/min increase in PCF, 95% CI 0.988 to 1.0, p=0.035); and to a lesser degree with increasing PCF of reflex cough (OR 0.998 for each 1 L/min increase in PCF, 95% CI 0.992 to 1.004, p=0.475). These data serve hypothesis generation. Further studies are needed to confirm these findings and validate their clinical utility.

Clinical trial registration number ISRCTN40298220 (post-results).

  • Pneumonia
  • Cough/Mechanisms/Pharmacology

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