普通人群中 14669 例慢性咳嗽的危险因素。
Risk Factors for Chronic Cough Among 14,669 Individuals From the General Population.
机构信息
Department of Internal Medicine, Section of Respiratory Medicine, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev; Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen; The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen.
The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen; Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev.
出版信息
Chest. 2017 Sep;152(3):563-573. doi: 10.1016/j.chest.2017.05.038. Epub 2017 Jun 15.
BACKGROUND
Risk factors for chronic cough in the general population have not been described systematically. We identified and ranked chronic cough risk factors at the individual and community level using data from 14,669 individuals from the Copenhagen General Population Study.
METHODS
Severity of chronic cough was assessed using the Leicester Cough Questionnaire (LCQ). We ranked chronic cough risk factors based on magnitude of age-adjusted ORs at the individual level and of the population attributable risks (PARs) at the community level.
RESULTS
Prevalence of chronic cough in the general population was 4% overall and 3% in never smokers, 4% in former smokers, and 8% in current smokers. Median score of the LCQ was 5.8 (25th-75th percentile, 5.0-6.3) for physical domain, 5.6 (25th-75th percentile, 4.6-6.3) for psychologic domain, 6.3 (25th-75th percentile, 5.5-6.8) for social domain, and 17.3 (25th- 75th percentile, 15.4-18.9) in total. At the level of the individual, age-adjusted ORs for the three top-ranked risk factors were 5.0 (95% CI, 1.4-18) for bronchiectasis, 2.6 (95% CI, 1.7-3.9) for asthma and 2.3 (95% CI, 1.5-3.4) for gastroesophageal reflux disease in never smokers, 7.1 (95% CI, 2.6-20) for bronchiectasis, 3.1 (95% CI, 2.2-4.4) for asthma and 2.2 (95% CI, 1.5-3.2) for occupational exposure to dust/fumes in former smokers, and 1.9 (95% CI, 1.3-2.9) for airflow limitation in current smokers. At the level of the community, the three top-ranked risk factors were female sex (PAR, 19%), asthma (PAR, 10%), and gastroesophageal reflux disease (PAR, 8%) in never smokers; abdominal obesity (PAR, 20%), low income (PAR, 20%), and asthma (PAR, 13%) in former smokers; and airflow limitation (PAR, 23%) in current smokers.
CONCLUSIONS
Risk factors for chronic cough differ at the level of the individual and community, and by smoking status. Strategies to prevent and treat modifiable chronic cough risk factors should be tailored accordingly.
背景
目前尚未系统描述一般人群慢性咳嗽的危险因素。我们使用来自哥本哈根普通人群研究的 14669 名个体的数据，确定并排列了个体和社区层面的慢性咳嗽危险因素，并对其进行了排名。
方法
使用莱斯特咳嗽问卷（LCQ）评估慢性咳嗽的严重程度。我们根据个体水平的年龄调整比值比（OR）和社区水平的人群归因风险（PAR）的大小对慢性咳嗽的危险因素进行了排名。
结果
一般人群慢性咳嗽的总体患病率为 4%，从不吸烟者为 3%，前吸烟者为 4%，现吸烟者为 8%。LCQ 量表的物理域中位数为 5.8（25%至 75%，5.0 至 6.3），心理域为 5.6（25%至 75%，4.6 至 6.3），社会域为 6.3（25%至 75%，5.5 至 6.8），总分为 17.3（25%至 75%，15.4 至 18.9）。在个体层面，从不吸烟者中排名前三的三个最高风险因素的年龄调整 OR 分别为：支气管扩张症 5.0（95%CI，1.4-18），哮喘 2.6（95%CI，1.7-3.9），胃食管反流病 2.3（95%CI，1.5-3.4）；支气管扩张症 7.1（95%CI，2.6-20），哮喘 3.1（95%CI，2.2-4.4），职业性粉尘或烟雾暴露 2.2（95%CI，1.5-3.2），以及现吸烟者的气流受限 1.9（95%CI，1.3-2.9）。在社区层面，从不吸烟者中排名前三的三个最高风险因素为女性（PAR，19%），哮喘（PAR，10%）和胃食管反流病（PAR，8%）；前吸烟者中排名前三的三个最高风险因素为腹部肥胖（PAR，20%），低收入（PAR，20%）和哮喘（PAR，13%）；而现吸烟者中排名前三的三个最高风险因素为气流受限（PAR，23%）。
结论
慢性咳嗽的危险因素在个体和社区层面以及吸烟状况方面存在差异。预防和治疗可改变的慢性咳嗽危险因素的策略应据此进行调整。
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