Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
Indian J Pediatr. 2024 Apr;91(4):337-343. doi: 10.1007/s12098-023-04632-7. Epub 2023 Jun 8.
To assess the use of a standardized evaluation algorithm [American College of Chest Physician (ACCP) 2006] in children with chronic cough.
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.
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.
This study demonstrated that the ACCP 2006 algorithm is effective in establishing the underlying etiology and managing children with chronic cough.
评估标准化评估算法[美国胸科医师学会（ACCP）2006 年]在慢性咳嗽儿童中的应用。
在这项前瞻性队列研究中，根据 ACCP 2006 诊断算法评估慢性咳嗽儿童。所有儿童均定期以 2-4 周的间隔进行随访。研究的终点是患者在治疗或自然状态下连续四周无咳嗽。
87 例研究儿童（52 例男性，35 例女性）的平均年龄为 11.9±3 岁。40 例（45.9%）患儿有特定咳嗽指针。12 例患儿胸片异常，47 例（54%）无特定咳嗽指针患儿中 6 例（6.9%）肺功能检查显示存在可逆转的阻塞性模式。经过详细评估，16 例（18.3%）患儿无明显异常，两周后复查。6 例患儿咳嗽自行缓解。其余 10 例患儿中，9 例给予吸入性皮质激素（ICS）（9 例）或抗生素（1 例）试验治疗。80 例（91.9%）患儿可明确诊断为特定的潜在病因。研究中最常见的病因是哮喘和哮喘样疾病（n=52；59.8%），其次是上气道咳嗽综合征（n=13；14.9%）和结核病（n=9；10.4%）。84 例（96.5%）患儿在随访期间咳嗽完全缓解。研究中平均缓解时间为 33.6±16.8 天。
本研究表明，ACCP 2006 算法可有效确定慢性咳嗽患儿的潜在病因并进行管理。
