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Cough Predicts Idiopathic Lung Fibrosis Disease Progression

Cough less likely in previous smokers; more likely in those with more advanced disease

FRIDAY, Oct. 21 (HealthDay News) -- Cough is common in patients with idiopathic pulmonary fibrosis (IPF), and is an independent predictor of disease progression, according to a study published in the August issue of Respirology.

Christopher J. Ryerson, M.D., from the University of California San Francisco, and colleagues described the characteristics and prognostic value of cough in IPF. Cough and other clinical variables were recorded for 242 individuals with IPF. Predictors of cough and disease progression were determined by logistic regression, with disease progression defined as 10 percent decline in forced vital capacity (FVC), 15 percent decline in carbon monoxide diffusion capacity, and lung transplantation or death within six months of a clinic visit. Cox proportional hazard analysis was used to analyze the relationship of cough with time to death or lung transplantation.

The investigators found that cough was reported in 84 percent of the participants. On multivariate analysis, disease severity as indicated by exertional desaturation (odds ratio [OR], 2.56) and lower FVC (OR, 0.76) was predictive of cough, and previous smokers were less likely to report cough (OR, 0.07). Cough predicted disease progression independent of disease severity (OR 4.97), and was likely to predict time to death or lung transplantation (hazard ratio, 1.78; 95 percent confidence interval, 0.94 to 3.35).

"The association of cough with disease progression and possible association with transplant-free survival in the current study suggests that the presence of cough may be an important and clinically useful predictor of poor prognosis in IPF," the authors write.

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