NDLI: Prevalence, aetiologies and prognosis of the symptom cough in primary care: a systematic review and meta-analysis

Content Provider	Springer Nature : BioMed Central
Author	Bergmann, Milena Haasenritter, Jörg Beidatsch, Dominik Schwarm, Sonja Hörner, Kaja Bösner, Stefan Grevenrath, Paula Schmidt, Laura Viniol, Annika Donner-Banzhoff, Norbert Becker, Annette
Abstract	Background Cough is a relevant reason for encounter in primary care. For evidence-based decision making, general practitioners need setting-specific knowledge about prevalences, pre-test probabilities, and prognosis. Accordingly, we performed a systematic review of symptom-evaluating studies evaluating cough as reason for encounter in primary care. Methods We conducted a search in MEDLINE and EMBASE. Eligibility criteria and methodological quality were assessed independently by two reviewers. We extracted data on prevalence, aetiologies and prognosis, and estimated the variation across studies. If justifiable in terms of heterogeneity, we performed a meta-analysis. Results We identified 21 eligible studies on prevalence, 12 on aetiology, and four on prognosis. Prevalence/incidence estimates were 3.8–4.2%/12.5% (Western primary care) and 10.3–13.8%/6.3–6.5% in Africa, Asia and South America. In Western countries the underlying diagnoses for acute cough or cough of all durations were respiratory tract infections (73–91.9%), influenza (6–15.2%), asthma (3.2–15%), laryngitis/tracheitis (3.6–9%), pneumonia (4.0–4.2%), COPD (0.5–3.3%), heart failure (0.3%), and suspected malignancy (0.2–1.8%). Median time for recovery was 9 to 11 days. Complete recovery was reported by 40.2- 67% of patients after two weeks, and by 79% after four weeks. About 21.1–35% of patients re-consulted; 0–1.3% of acute cough patients were hospitalized, none died. Evidence is missing concerning subacute and chronic cough. Conclusion Prevalences and incidences of cough are high and show regional variation. Acute cough, mainly caused by respiratory tract infections, is usually self-limiting (supporting a “wait-and-see” strategy). We have no setting-specific evidence to support current guideline recommendations concerning subacute or chronic cough in Western primary care. Our study presents epidemiological data under non non-pandemic conditions. It will be interesting to compare these data to future research results of the post-pandemic era.
Related Links	https://bmcprimcare.biomedcentral.com/counter/pdf/10.1186/s12875-021-01501-0.pdf
Ending Page	19
Page Count	19
Starting Page	1
File Format	HTM / HTML
ISSN	27314553
DOI	10.1186/s12875-021-01501-0
Journal	BMC Primary Care
Issue Number	1
Volume Number	22
Language	English
Publisher	BioMed Central
Publisher Date	2021-07-12
Access Restriction	Open
Subject Keyword	General Practice Family Medicine Primary Care Medicine Cough Primary care Diagnosis Prevalence Aetiology Prognosis Systematic review Symptom-evaluating study
Content Type	Text
Resource Type	Article
Subject	Family Practice
Journal Impact Factor	3.2/2023
5-Year Journal Impact Factor	3.3/2023

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1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
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