Abstract
Objective
To assess the use of a standardized evaluation algorithm [American College of Chest Physician (ACCP) 2006] in children with chronic cough.
Methods
In this prospective cohort study, children with chronic cough were evaluated as per the ACCP 2006 diagnostic algorithm. All children were followed regularly at an interval of 2–4 wk. The study’s endpoint was for the patient being cough free for four weeks either following treatment or naturally.
Results
The mean age of the 87 studied children (52 male, 35 female) was 11.9±3 y. Forty children (45.9%) had specific cough pointers on history and examination. Radiograph showed abnormalities in 12 (13.8%) children, and spirometry showed a reversible obstructive pattern on spirometry in 6 (6.9%) among 47 (54%) children without specific cough pointers. After a detailed evaluation, 16 (18.3%) children had no remarkable findings and were reviewed after two weeks. Spontaneous resolution of cough occurred in 6 children. A trial of inhalational corticosteroids (ICS) (9 children) or antibiotics (1 child) was given to the rest of the ten children. Specific underlying diagnoses could be established in 80 (91.9%) children. The most common etiology identified in the study was asthma and asthma-like illnesses (n = 52; 59.8%), followed by upper airway cough syndrome (n = 13; 14.9%) and tuberculosis (n = 9; 10.4%). Eighty-four (96.5%) children had complete resolution of cough during follow-up. The mean time to resolution in the study was 33.6±16.8 d.
Conclusions
This study demonstrated that the ACCP 2006 algorithm is effective in establishing the underlying etiology and managing children with chronic cough.
Similar content being viewed by others
References
Chang AB, Glomb WB. Guidelines for evaluating chronic cough in pediatrics: ACCP evidence-based clinical practice guidelines. Chest. 2006;129:260S–83S.
Canning BJ, Chang AB, Bolser DC, Smith JA, Mazzone SB, McGarvey L. Anatomy and neurophysiology of cough: CHEST Guideline and Expert Panel report. Chest. 2014;146:1633–48.
Kasi AS, Kamerman-Kretzmer RJ, Cough. Pediatr Rev. 2019;40:157–67.
Asilsoy S, Bayram E, Agin H, et al. Evaluation of chronic cough in children. Chest. 2008;134:1122–8.
Marchant JM, Masters IB, Taylor SM, Cox NC, Seymour GJ, Chang AB. Evaluation and outcome of young children with chronic cough. Chest. 2006;129:1132–41.
Chang AB, Oppenheimer JJ, Weinberger M, et al. CHEST Expert Cough Panel. Use of management pathways or algorithms in children with chronic cough: CHEST Guideline and Expert Panel Report. Chest. 2017;151:875–83.
Chang AB, Robertson CF, Van Asperen PP, et al. A cough algorithm for chronic cough in children: a multicenter, randomized controlled study. Pediatrics. 2013;131:e1576–83.
Mccallum GB, Bailey EJ, Morris PS, Chang AB. Clinical pathways for chronic cough in children. Cochrane database Syst Rev. 2014;9:CD006595.
Guleria R, Dhar R, Mahashur A, et al. Indian consensus on diagnosis of cough at primary care setting. J Assoc Physicians India. 2019;67:92–8.
Lahiri KR, Landge AA. Approach to chronic cough. Indian J Pediatr. 2014;81:1027–32.
Karabel M, Kelekçi S, Karabel D, Gürkan MF. The evaluation of children with prolonged cough accompanied by American College of chest Physicians guidelines. Clin Respir J. 2014;8:152–9.
Gedik AH, Cakir E, Torun E, et al. Evaluation of 563 children with chronic cough accompanied by a new clinical algorithm. Ital J Pediatr. 2015. https://doi.org/10.1186/s13052-015-0180-0.
Chang AB, Robertson CF, Van Asperen PP, et al. A multicenter study on chronic cough in children: Burden and etiologies based on a standardized management pathway. Chest. 2012;142:943–50.
Dani VS, Mogre SS, Saoji R. Evaluation of chronic cough in children: clinical and diagnostic spectrum and outcome of specific therapy. Indian Pediatr. 2002;39:63–9.
Rehman A, Waraich MM, Ullah I. Algorithm for the diagnosis of chronic cough in children 6 to 59-months. Pakistan Paediatr J. 2009;33:30–8.
Usta Guc B, Asilsoy S, Durmaz C. The assessment and management of chronic cough in children according to the british thoracic society guidelines: descriptive, prospective, clinical trial. Clin Respir J. 2014;8:330–7.
Author information
Authors and Affiliations
Contributions
NR prepared the first draft of the manuscript. PK redefined the research idea and validated the data collection. JPG developed the research idea, analysed data, and edited the manuscript. JPG will act as the guarantor for this manuscript.
Corresponding author
Ethics declarations
Conflict of Interest
None.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Electronic Supplementary Material
Below is the link to the electronic supplementary material.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Rajvanshi, N., Kumar, P. & Goyal, J.P. Evaluation of Chronic Cough in Children Using Management Algorithm: A Prospective Cohort Study. Indian J Pediatr 91, 337–343 (2024). https://doi.org/10.1007/s12098-023-04632-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12098-023-04632-7