Pediatric Quality-of-Life Scores Following a Multidisciplinary Aerodigestive Team Approach to Manage Chronic Cough. (November 2020)

• Record Type: Journal Article
• Authors: Yibrehu, Betel A.; Krakovsky, Gina M.; Rana, Md Sohel; Pillai, Dinesh K.; Sehgal, Sona; Collins, Maura E.; Gatti, Meagan L.; Bauman, Nancy M.
• Is Part Of: Annals of otology, rhinology & laryngology. Volume 129:Number 11(2020)
• Page Start: 1088
• Page End: 1094
• Publication Date: 2020-11
• Subjects: cough -- pediatric airway -- patient reported outcomes; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0003489420931558
• Languages: English
• ISSNs: 0003-4894

Abstract

Objectives: Chronic recalcitrant cough is present in 2/3 of pediatric patients evaluated in our tertiary-care multidisciplinary aerodigestive clinic (ADC). This study aimed to determine the impact of chronic cough and efficacy of ADC treatment using the validated Pediatric-Cough Quality-of-Life-27 tool (PC-QOL-27). Methods: The PC-QOL-27 survey was administered to ADC patients with chronic cough at initial clinic visit and 6 to 12 weeks after cough management. Pre and post survey scores, demographic data, treatment and evaluation season were collected over 16 months. Results: Twenty parents completed pre and post PC-QOL-27 surveys (mean 12.1 weeks later). Patient median age was 6.04 years (IQR: 2.2-10.44 years). A total of 65% were males and 65% were African American. Management was tailored based on clinical assessment and diagnostic studies, including direct laryngoscopy/bronchoscopy (4), pulmonary function tests (PFT's 9), esophagogastroduodenoscopy (9), and flexible bronchoscopy/lavage (9). Following ADC management, changes in physical, social and psychological domain scores of the PC-QOL-27 each met the threshold for minimal clinical important difference (MCID) indicating a clinically meaningful improvement. Improvements were most notable in the physical domain where post survey scores significantly improved from pre-survey scores ( P = .009) regardless of age, gender, ethnicity, history of endoscopy and season. Conclusions: The physical impact of chronic cough in pediatric patients who failed prior management by a single specialist was lessened by an ADC team approach to management.