Impact of Chronic Cough on Health-Related Quality of Life in the Korean Adult General Population: The Korean National Health and Nutrition Examination Survey 2010-2016

Abstract

Purpose: Chronic cough is a prevalent condition in the community and may pose considerable impairment to quality of life (QoL). However, its disease burden remains largely undefined in the general population. The present study investigated the relationship between chronic cough and health-related QoL in a Korean nationwide population database, with an emphasis on clinical conditions which may confound the impact of cough. Methods: This study analyzed cross-sectional datasets of adults (aged >= 40 years) in the Korean National Health and Nutrition Examination Survey 2010-2016. Health-related QoL was assessed using the 3-level EuroQoL 5-dimension component (EQ-5D-3L) index score. The presence of chronic cough and other conditions were defined using structured questionnaires. Results: The prevalence of chronic cough was 3.48% +/- 0.17% among adults aged >= 40 years. The overall EQ-5D-3L index score was significantly lower in subjects with than without chronic cough (0.79 +/- 0.01 vs. 0.86 +/- 0.00, P < 0.001). In subgroup analyses by age and sex, chronic cough had a notably large impact on QoL in women aged >= 65 years (vs. those without chronic cough: 0.55 +/- 0.04 vs. 0.70 +/- 0.01, P < 0.001), although the mean difference in the scores exceeded the minimally important difference score of 0.05 in all subgroups. In multivariate analyses, chronic cough was significantly associated with QoL, independent of confounders including depression, arthritis, asthma, and chronic obstructive pulmonary disease. In dimension analyses, chronic cough was more associated with anxiety/depression, pain/discomfort, and usual activities than with self-care or mobility in the EQ-5D. Conclusions: The present study demonstrated significant associations between chronic cough and health-related QoL in a nationwide large general adult population aged >= 40 years, which were independent of clinical confounders. The impact of chronic cough was greater in women aged >= 65 years. These findings indicate a considerable burden of chronic cough in the general population and warrant further investigations to assess the disease burden of chronic cough in a global scale.