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BMC Primary Care
Published in: BMC Primary Care 1/2021

01-12-2021 | Cough | Research article

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

Authors: Milena Bergmann, Jörg Haasenritter, Dominik Beidatsch, Sonja Schwarm, Kaja Hörner, Stefan Bösner, Paula Grevenrath, Laura Schmidt, Annika Viniol, Norbert Donner-Banzhoff, Annette Becker

Published in: BMC Primary Care | Issue 1/2021

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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.
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Metadata
Title
Prevalence, aetiologies and prognosis of the symptom cough in primary care: a systematic review and meta-analysis
Authors
Milena Bergmann
Jörg Haasenritter
Dominik Beidatsch
Sonja Schwarm
Kaja Hörner
Stefan Bösner
Paula Grevenrath
Laura Schmidt
Annika Viniol
Norbert Donner-Banzhoff
Annette Becker
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2021
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-021-01501-0

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