Won Ha Kyeong, Lee Ji Hyang, An Jin, Sohn Kyoung Hee, Kang Min Gyu, Kang Sung Yoon, Morice Alyn H, Cho Sang Heon, Song Woo Jung
Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Korea.
Department of Allergy and Clinical Immunology, Airway Sensation and Cough Research Laboratory, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Allergy Asthma Immunol Res. 2020 Nov;12(6):964-979. doi: 10.4168/aair.2020.12.6.964.
Chronic cough is a prevalent condition in the community and may pose considerable impairment to quality of life (QoL). However, its disease burden remains largely undefined in the general population. The present study investigated the relationship between chronic cough and health-related QoL in a Korean nationwide population database, with an emphasis on clinical conditions which may confound the impact of cough.
This study analyzed cross-sectional datasets of adults (aged ≥ 40 years) in the Korean National Health and Nutrition Examination Survey 2010-2016. Health-related QoL was assessed using the 3-level EuroQoL 5-dimension component (EQ-5D-3L) index score. The presence of chronic cough and other conditions were defined using structured questionnaires.
The prevalence of chronic cough was 3.48% ± 0.17% among adults aged ≥ 40 years. The overall EQ-5D-3L index score was significantly lower in subjects with than without chronic cough (0.79 ± 0.01 vs. 0.86 ± 0.00, < 0.001). In subgroup analyses by age and sex, chronic cough had a notably large impact on QoL in women aged ≥ 65 years (vs. those without chronic cough: 0.55 ± 0.04 vs. 0.70 ± 0.01, < 0.001), although the mean difference in the scores exceeded the minimally important difference score of 0.05 in all subgroups. In multivariate analyses, chronic cough was significantly associated with QoL, independent of confounders including depression, arthritis, asthma, and chronic obstructive pulmonary disease. In dimension analyses, chronic cough was more associated with anxiety/depression, pain/discomfort, and usual activities than with self-care or mobility in the EQ-5D.
The present study demonstrated significant associations between chronic cough and health-related QoL in a nationwide large general adult population aged ≥ 40 years, which were independent of clinical confounders. The impact of chronic cough was greater in women aged ≥ 65 years. These findings indicate a considerable burden of chronic cough in the general population and warrant further investigations to assess the disease burden of chronic cough in a global scale.
慢性咳嗽在社区中很常见,可能对生活质量(QoL)造成相当大的损害。然而,在普通人群中其疾病负担仍 largely 未明确。本研究在韩国全国人口数据库中调查了慢性咳嗽与健康相关生活质量之间的关系,重点关注可能混淆咳嗽影响的临床状况。
本研究分析了2010 - 2016年韩国国家健康与营养检查调查中成年人(年龄≥40岁)的横断面数据集。使用3级欧洲五维健康量表(EQ - 5D - 3L)指数评分评估健康相关生活质量。通过结构化问卷确定慢性咳嗽和其他状况的存在。
在年龄≥40岁的成年人中,慢性咳嗽的患病率为3.48%±0.17%。有慢性咳嗽的受试者的总体EQ - 5D - 3L指数评分显著低于无慢性咳嗽者(0.79±0.01对0.86±0.00,<0.001)。在按年龄和性别进行的亚组分析中,慢性咳嗽对≥65岁女性的生活质量有显著较大影响(与无慢性咳嗽者相比:0.55±0.04对0.70±0.01,<0.001),尽管所有亚组中评分的平均差异均超过了最小重要差异评分0.05。在多变量分析中,慢性咳嗽与生活质量显著相关,独立于包括抑郁症、关节炎、哮喘和慢性阻塞性肺疾病在内的混杂因素。在维度分析中,慢性咳嗽在EQ - 5D中与焦虑/抑郁、疼痛/不适和日常活动的关联比与自我护理或行动能力的关联更强。
本研究表明,在全国范围内年龄≥40岁的大型普通成年人群中,慢性咳嗽与健康相关生活质量之间存在显著关联,且独立于临床混杂因素。慢性咳嗽对≥65岁女性的影响更大。这些发现表明普通人群中慢性咳嗽负担较重,值得进一步研究以在全球范围内评估慢性咳嗽的疾病负担。