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A Comparison of Gender Differences in Health-Related Quality of Life in Acute and Chronic Coughers^*

^* From the Departments of Medicine (Ms. French and Dr. Irwin) and Psychiatry (Dr. Fletcher), University of Massachusetts Medical School, Worcester, MA.

Correspondence to: Richard S. Irwin, MD, FCCP, University of Massachusetts Medical School, Division of Pulmonary, Allergy, and Critical Care Medicine, 55 Lake Ave North, Worcester, MA 01655; e-mail: IrwinR{at}ummhc.org

Study objectives: To determine whether the health-related quality of life (HRQOL) of women and men is adversely affected by acute cough (AC), affected differently by AC, or affected differently by AC and chronic cough (CC).

Design: Analysis of consecutively and prospectively collected AC data from two time periods, and previously prospectively and consecutively collected CC data that had not been previously analyzed. When no differences were found in the two cohorts of acute coughers, as was the case in the greatest majority of comparisons, the two samples were pooled, treated as one sample of acute coughers, and compared with chronic coughers.

Settings: Primary care and cough clinics in an academic, tertiary care medical center.

Participants: Subjects prospectively seeking medical attention complaining of AC for < 3 weeks and CC for at least 8 weeks.

Measurement: All subjects completed the cough-specific quality-of-life questionnaire (CQLQ) prior to contact with a physician and medical intervention.

Results: Of 62 acute coughers, 32 were women and 30 were men (p = 0.25). Total CQLQ scores for women were 59.9, and for men they were 59.2. (There was no difference in total CQLQ scores in the two cohorts of acute coughers.) The mean (± SD) combined total CQLQ score of women and men of 59.57 ± 10.4 was higher (t₉₀ = 11.39; p < 0.0001) than the score in an historical control group of women and men who were not complaining of cough (35.06 ± 8.40). In acute coughers, there were no gender differences in the total or six subscale scores when the two cohorts were considered separately or combined. Of 172 chronic coughers, 116 were women and 56 were men (p < 0.0001). Women with CC rated themselves significantly higher than did women with AC on the total CQLQ and on five of the six subscales. Women with AC did not rate themselves higher on any of the CQLQ subscales. Total CQLQ scores for men with AC and CC were similar. Men with CC, compared with men with AC, scored significantly higher in two of six subscales (and significantly lower in one subscale) and scored similarly in three subscales.

Conclusions: AC, like CC, adversely affected the HRQOL of women and men. Unlike CC, AC did not adversely affect the HRQOL of women more than men. The HRQOL of women is more adversely affected than the HRQOL of men, the longer a cough lasts.

Key Words: acute cough • gender differences in acute cough • gender differences in acute and chronic cough • gender differences in cough and quality of life • health-related quality of life • quality of life