Article Text

Download PDFPDF
Utility of signs and symptoms of chronic cough in predicting specific cause in children
  1. J M Marchant1,2,
  2. I B Masters1,2,
  3. S M Taylor1,
  4. A B Chang1,2
  1. 1Department of Respiratory Medicine, Royal Children’s Hospital, Brisbane, Australia
  2. 2School of Medicine, Discipline of Paediatrics and Child Health, University of Queensland, Royal Children’s Hospital, Brisbane, Australia
  1. Correspondence to:
    Dr J M Marchant
    Department of Respiratory Medicine, Royal Children’s Hospital, Herston, 4029, Queensland, Australia; Julie_Marchant{at}health.qld.gov.au

Abstract

Background: Paediatricians rely on cough descriptors to direct them to the level of investigations needed for a child presenting with chronic cough, yet there is a lack of published data to support this approach. A study was undertaken to evaluate (1) whether historical cough pointers can predict which children have a specific cause for their cough and (2) the usefulness of chest radiography and spirometry as standard investigations in children with chronic cough.

Methods: This was a prospective cohort study of children referred to a tertiary hospital with a cough lasting >3 weeks between June 2002 and July 2004. All included children completed a detailed history and examination using a standardised data collection sheet and followed a pathway of investigation until a diagnosis was made.

Results: In 100 consecutively recruited children of median age 2.8 years, the best predictor of specific cough observed was a moist cough at the time of consultation with an odds ratio (OR) of 9.34 (95% CI 3.49 to 25.03). Chest examination or chest radiographic abnormalities were also predictive with OR 3.60 (95% CI 1.31 to 9.90) and 3.16 (95% CI 1.32 to 7.62), respectively. The most significant historical pointer for predicting a specific cause of the cough was a parental history of moist cough (sensitivity 96%, specificity 26%, positive predictive value 74%).

Conclusions: The most useful clinical marker in predicting specific cough is the presence of a daily moist cough. Both chest examination and chest radiographic abnormalities are also useful in predicting whether children have a specific cause of their cough.

  • chronic cough
  • children
  • diagnosis

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles

  • Airwaves
    Wisia Wedzicha