Background <p>Patients with chronic cough (CC) frequently exhibit swallowing dysfunction related to laryngeal hypersensitivity. This study aimed to evaluate the clinical utility of swallowing time (ST) measurement in the etiological assessment and management of CC.</p> Methods <p>The ST was measured in 176 patients with CC and 82 healthy controls. Follow-up assessments were conducted among 49 patients with gastroesophageal reflux-associated cough (GERC) and 86 with other causes of CC (non-GERC). Associations between ST and clinical features were analyzed, and the predictive performance of ST for guiding treatment intensification was evaluated in GERC patients and compared with the Hull Airway Reflux Questionnaire (HARQ) and Reflux Symptom Index (RSI).</p> Results <p>The ST was significantly shorter in CC than in healthy controls (1.167 ± 0.446&#xa0;s <i>vs.</i> 1.798 ± 0.721&#xa0;s, <i>p</i> &lt; 0.001), and varied significantly among etiological subtypes (<i>p</i> = 0.019). ST was notably reduced in GERC compared to non-GERC patients, showing a specificity of 85.7% but sensitivity of 46.5%. In GERC patients, ST correlated negatively with RSI and HARQ scores, and positively with capsaicin cough threshold (C5). Shorter ST (&lt; 1.015&#xa0;s) was associated with proximal reflux events and greater need for intensified anti-reflux therapy (χ<sup>2</sup> = 17.686, <i>p</i> &lt; 0.001). ST also exhibited superior predictive accuracy over HARQ and RSI scores.</p> Conclusion <p>Swallowing reflex hypersensitivity is prevalent in CC, especially in GERC. ST assessment provides valuable information for etiological differentiation and helps guide optimal treatment intensification in GERC patients.</p>

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Shorten swallowing time and its implication in patients with chronic cough: a prospective observational study

  • Li Zhang,
  • Jing Pan,
  • Wenbo Shi,
  • Mengru Zhang,
  • Alimire Aierken,
  • Ran Dong,
  • Qiang Chen,
  • Zhongmin Qiu

摘要

Background

Patients with chronic cough (CC) frequently exhibit swallowing dysfunction related to laryngeal hypersensitivity. This study aimed to evaluate the clinical utility of swallowing time (ST) measurement in the etiological assessment and management of CC.

Methods

The ST was measured in 176 patients with CC and 82 healthy controls. Follow-up assessments were conducted among 49 patients with gastroesophageal reflux-associated cough (GERC) and 86 with other causes of CC (non-GERC). Associations between ST and clinical features were analyzed, and the predictive performance of ST for guiding treatment intensification was evaluated in GERC patients and compared with the Hull Airway Reflux Questionnaire (HARQ) and Reflux Symptom Index (RSI).

Results

The ST was significantly shorter in CC than in healthy controls (1.167 ± 0.446 s vs. 1.798 ± 0.721 s, p < 0.001), and varied significantly among etiological subtypes (p = 0.019). ST was notably reduced in GERC compared to non-GERC patients, showing a specificity of 85.7% but sensitivity of 46.5%. In GERC patients, ST correlated negatively with RSI and HARQ scores, and positively with capsaicin cough threshold (C5). Shorter ST (< 1.015 s) was associated with proximal reflux events and greater need for intensified anti-reflux therapy (χ2 = 17.686, p < 0.001). ST also exhibited superior predictive accuracy over HARQ and RSI scores.

Conclusion

Swallowing reflex hypersensitivity is prevalent in CC, especially in GERC. ST assessment provides valuable information for etiological differentiation and helps guide optimal treatment intensification in GERC patients.