Tos crónica de escasa respuesta al tratamiento e incidencia de reflujo gastroesofágico

Our objective was to evaluate the association between chronic cough and the variables that could influence the course of the cough in order to develop a profile for coughers with poor response to treatment. In our Chronic Cough Unit, 192 patients were prospectively followed up for 3 months, during which time all the variables that could influence the cough reflex were evaluated and treated. The improvement in cough was evaluated by the response of the patients to a visual analogical scale with scores from 0 to 4, considering 0 as «no changes» and an improvement as a score of 3 or 4. The cough was considered to have little response to treatment if it persisted without any improvement for more than 3 months. Using a multivariate logistic regression model, we input variables that were candidates for being associated with the improvement in cough 3 months later. In the final profile model of the cougher with poor prognosis, three variables remained: sex, typical gastroesophageal reflux and psychosocial disorder. Being male is associated with an improvement in cough 3 months later (OR = 2.10, 95%CI 1.00-4.38). However, having gastroesophageal reflux is associated with a reduction in the improvement three months later in 55% (OR = 0.45, 95%CI 0.24-0.84), and having a psychosocial disorder reduces the probability for improvement of the cough 3 months later in 70% (OR = 0.30, 95%CI 0.09-1.03).