ORIGINAL ARTICLE

Relation between measurements of cough severity

A B Chang¹, P D Phelan², C F Robertson³, R G D Roberts³, S M Sawyer²

¹ Department of Respiratory Medicine, Royal Children’s Hospital Foundation, Brisbane and University of Queensland
² Department of Paediatrics, University of Melbourne, Parkville, Victoria 3052
³ Department of Respiratory Medicine, Royal Children’s Hospital, Parkville, Victoria 3052, Australia

Correspondence to:
Correspondence to:
Assoc Professor A Chang, Dept of Respiratory Medicine, Royal Children’s Hospital, Herston, Queensland 4029, Australia;
annechang{at}ausdoctors.net

Background: In asthma, measurements of airway inflammation correlate poorly with clinical markers and airway hyperresponsiveness. While the relation between determinants of asthma severity is known, that for cough is unknown. We hypothesised that cough sensitivity changes relate to changes in cough scores and objectively measured cough frequency.

Aims: To examine the relation between commonly used outcome measurements of cough severity in children.

Methods: The concentration of capsaicin causing two and five or more coughs (C2 and C5 respectively), cough frequency objectively measured using an ambulatory cough meter, and parent and child recorded subjective cough scores were determined in 40 children with recurrent cough on two occasions.

Results: On occasion one, log cough frequency significantly correlated with parent and child recorded log cough score (r_s = 0.32, p = 0.05; and r_s = 0.32, p = 0.046 respectively) and significantly negatively correlated with log C2 (r_s= -0.5, p = 0.005). Subjective cough scores did not relate to either C2 or C5. On occasion two, the relation between cough frequency and C2 and C5 measures was lost, but C2 had a weak but significant relation to parent recorded cough score (r_s = -0.38, p = 0.047). When the changes in the log values were determined, C5 but not C2 significantly related to cough frequency.

Conclusion: In children, measures of cough sensitivity have a weak relation with cough frequency. Subjective cough scores have a stronger and consistent relation with cough frequency. These cough severity indices measure different aspects of cough. The choice of indices depends on the reason for performing the measurement.

Keywords: cough; cough meter; cough receptor sensitivity

Abbreviations: CRS, cough receptor sensitivity; EMG, electromyogram; FEV, forced expiratory volume; VAS, visual analogue scale

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