Abstract

Objectives: To evaluate the prevalence of significant pulmonary diseases among Chinese adult patients presenting with persistent cough lasting for 3 weeks or more in primary care in Hong Kong.

Methods: Based on the data generated from the hospital authority clinical data analysis and reporting system, 880 Chinese adult patients who presented with cough as the predominant symptom lasting for 3 weeks or more in two general out-patient clinics in Hong Kong from 1^st January 2017 to 31^st December 2017 were included in this study. We have evaluated the prevalence of significant pulmonary diseases including lung cancer, non-tuberculosis pneumonia, pulmonary tuberculosis, asthma, bronchiectasis, chronic obstructive pulmonary disease and interstitial lung diseases among the subjects. The proportions of positive pulmonary investigation findings arranged in the study sites and the associated factors for significant pulmonary diseases were also analysed.

Results: The prevalence of significant pulmonary diseases among the studied subjects was 19.2% (169/880). The proportions of positive investigation findings among those with investigations done were 32.0%, 24.7%, 6.2% and 36.7% for chest radiograph, sputum for bacterial culture, sputum for acid-fast bacilli culture and spirometry respectively. The presence of red flag symptoms (OR 3.01, p<0.001), history of other chronic lung diseases (OR 6.82, p<0.001) and older age (OR 1.02, p=0.010) had strong associations with significant pulmonary diseases.

Conclusion: One fifth of the studied subjects had significant pulmonary diseases. Comprehensive clinical evaluation was warranted in these patients for timely detection and intervention of underlying significant pulmonary diseases.

Keywords: Pulmonary diseases; Subacute cough; Chronic cough; Primary care; Asthma; Chronic obstructive pulmonary disease; Bronchiectasis, Pneumonia; Pulmonary tuberculosis; Lung cancer