University of Oulu

Saari, E., Mononen, M., Hasala, H. et al. Characteristics of idiopathic pulmonary fibrosis -associated cough. a case-control study. BMC Pulm Med 23, 179 (2023).

Characteristics of idiopathic pulmonary fibrosis -associated cough : a case-control study

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Author: Saari, Eeva1,2; Mononen, Minna1; Hasala, Hannele3;
Organizations: 1Division of Respiratory Medicine, Institute of Clinical Medicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, 1627, 70211, Kuopio, PO, Finland
2Center of Medicine and Clinical Research, Division of Respiratory Medicine, Kuopio University Hospital, PO 100, 70029, Kuopio, Finland
3Department of Respiratory Medicine, Tampere University Hospital, PO 2000, 33521, Tampere, Finland
4Health Care Services for Prisoners, Mehiläinen Terveyspalvelut Oy, Kauppakatu 39A, 70110, Kuopio, Finland
5Research Unit of Internal Medicine, University of Oulu, PO 500, 90400, Oulu, Finland
6Center of Internal Medicine and Respiratory Medicine and Medical Research Center (MRC) Oulu, Oulu University Hospital, PO 20, 90029, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.1 MB)
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Language: English
Published: Springer Nature, 2023
Publish Date: 2023-08-22


Background: Most patients with idiopathic pulmonary fibrosis (IPF) complain of cough. IPF-associated cough is widely characterized as dry or non-productive. The aim of this study was to compare chronic cough in early stage IPF patients to cough in subjects with chronic cough from a community-based sample and, especially, to investigate whether cough in IPF is less productive than chronic cough in a community-based sample.

Methods: The IPF cough population consisted of 46 biopsy-confirmed patients who complained of chronic cough. Control population consisted of subjects with chronic cough, gathered by a community-based email survey sent to public service employees and the Finnish Pensioners’ Federation. A case-control setting was applied by having four age, gender, and smoking-status matched subjects from the community sample for each IPF cough patient. A cough specific quality of life questionnaire (Leicester Cough Questionnaire (LCQ)) was filled in by all subjects. The LCQ questionnaire contains 19 questions, each question is scored from 1 to 7 and total score from 3 to 21 with a smaller value indicating more severe impairment.

Results: The sputum production frequency, as assessed by LCQ question 2, was 5.0 (3.0-6.0) in the IPF chronic cough population and 5.0 (3.0–6.0) in the community-based chronic cough population (median and interquartile range p= 0.72). The LCQ total score was 14.8 (11.5-18.1) in the IPF chronic cough population and 15.4 (13.0–17.5) in the community-based chronic cough population (p=0.76). The domain impact scores were physical, 4.9 (3.9–6.1) vs. 5.1 (4.5–5.6) (p=0.80); psychological, 4.6 (3.7–5.9) vs. 4.7 (3.9–5.7) (p=0.90); and social, 5.5 (3.7–6.5) vs. 5.5 (4.5–6.3) (p=0.84), respectively. Furthermore, cough response to paint or fumes, cough disturbing sleep, and cough frequency per day did not differ between the groups.

Conclusion: Cough in early stage IPF patients was not distinguishable from chronic cough in the community-based population by LCQ. Especially, there was no difference in the self-reported frequency of cough-associated sputum production.

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Series: BMC pulmonary medicine
ISSN: 1471-2466
ISSN-E: 1471-2466
ISSN-L: 1471-2466
Volume: 23
Issue: 1
Article number: 179
DOI: 10.1186/s12890-023-02476-7
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Funding: This study was supported by the Foundation of the Finnish Anti-Tuberculosis Association, the Finnish Cultural Foundation, Väinö and Laina Kivi Foundation, the Research Foundation of the Pulmonary Diseases, Jalmari and Rauha Ahokas Foundation, The Respiratory Foundation of the Kuopio Region, The Research Foundation of Kuopio university hospital. The funding had no role in the design of the study neither in collection, analysis, or interpretation of data or the writing up of the manuscript.
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