title: Higher cough flow is associated with lower risk of pneumonia in acute stroke.
abstract: There is little available evidence to demonstrate how cough strength mediates the risk of aspiration-related pneumonia in acute stroke. Our secondary analysis of trial data indicates that risk of pneumonia reduces with increasing peak cough flow (PCF) of voluntary cough (OR 0.994 for each 1 L/min increase in PCF, 95% CI 0.988 to 1.0, p=0.035); and to a lesser degree with increasing PCF of reflex cough (OR 0.998 for each 1 L/min increase in PCF, 95% CI 0.992 to 1.004, p=0.475). These data serve hypothesis generation. Further studies are needed to confirm these findings and validate their clinical utility.
  
  
  BACKGROUND
  ISRCTN40298220 (post-results).
authors.affiliation: Faculty of Health, Social Care and Education, St George's, University of London, London, UK.
authors.forename: Stefan T
authors.initials: ST
authors.lastname: Kulnik
authors.affiliation: Division of Asthma, Allergy & Lung Biology, Faculty of Life Sciences and Medicine, King's College London, London, UK.
authors.forename: Surinder S
authors.initials: SS
authors.lastname: Birring
authors.affiliation: Department of Biostatistics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
authors.forename: John
authors.initials: J
authors.lastname: Hodsoll
authors.affiliation: Division of Asthma, Allergy & Lung Biology, Faculty of Life Sciences and Medicine, King's College London, London, UK.
authors.forename: John
authors.initials: J
authors.lastname: Moxham
authors.affiliation: Division of Asthma, Allergy & Lung Biology, Faculty of Life Sciences and Medicine, King's College London, London, UK.
authors.forename: Gerrard F
authors.initials: GF
authors.lastname: Rafferty
authors.affiliation: Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
authors.forename: Lalit
authors.initials: L
authors.lastname: Kalra
mesh_terms: D003371:Cough / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D010366:Peak Expiratory Flow Rate; D011015:Pneumonia, Aspiration / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000150:complications*
keywords: Cough/Mechanisms/Pharmacology; Pneumonia