Cough presentation and cough-related healthcare utilization in tertiary care: analysis of routinely collected academic institutional database

Purpose: Routinely collected data (RCD) from electronic health records (EHR) are useful for studying disease epidemiology in the real world. We examined cough presentation and cough-related healthcare utilization using an academic institutional EHR database in Korea. Methods: : This is a retrospective cohort study of patients with subacute (3–8 weeks) or chronic cough (>8 weeks in duration) referred to allergy and asthma clinics. Cases were identified using the search of the chief complaint in the data fields. Structured data were analyzed, including demographics, medical history, symptoms, and diagnostic tests. Healthcare utilization for 1 year was assessed for drug prescriptions, additional tests, or outpatient visits. Results: : Among 28,312 new referrals for 8 years, cough was the chief complaint in 13,223 cases (46.7%); 3,810 subacute and 7,150 chronic cough patients were analyzed. Common demographic profile was middle-aged woman (mean age 52.1 years, and female 63%). Cough was frequently accompanied by anterior nasal (about 50%), lower airway (30%), or acid reflux disease symptoms (20%), and by test abnormalities in chest X-rays (14%), spirometry (23%), or T2 inflammation markers (40%). Chronic cough patients frequently required additional tests (chest CT scan: 24%), drug prescriptions (codeine: 21.5% and oral steroids: 9.9%), and long-term healthcare utilization (16.0%) for 1 year. Conclusions: : This RCD analysis suggests that cough is a common chief complaint at allergy and asthma clinics, but the clinical presentation may be heterogeneous. Further studies are needed to understand long-term outcomes and reduce the disease burden.