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Relationship between supramaximal flow during cough and mortality in motor neurone disease

M.B. Chaudri, C. Liu, R. Hubbard, D. Jefferson, W.J. Kinnear
European Respiratory Journal 2002 19: 434-438; DOI: 10.1183/09031936.02.00082702
M.B. Chaudri
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C. Liu
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R. Hubbard
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D. Jefferson
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W.J. Kinnear
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  • Fig. 1.—
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    Fig. 1.—

    a) A series of cough spikes superimposed on the maximal expiratory flow volume curve. b) An example of a patient who was unable to produce cough spikes. c) A grossly distorted cough flow/volume curve in a bulbar patient.

  • Fig. 2.—
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    Fig. 2.—

    Comparison of vital capacity (VC) % predicted (% pred) in patients without cough spikes (♦) and those with cough spikes (○).

  • Fig. 3.—
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    Fig. 3.—

    Kaplan-Meier curve comparing survival % predicted (% pred) in patients with spikes (○) and those without spikes (□). *: p<0.05.

Tables

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  • Table 1—

    Baseline characteristics

    No spikes (Group one)Spikes (Group two)p‐value
    Patients n2924‐
    Age yrs60.52±14.2159.92±10.65ns
    Sex M:F20:922:2ns
    Disease duration months35.15±32.4827.86±22.75ns
    Bulbar214 #
    BMI kg·m−222±3.3325.63±3.73***
    VC % pred61.62±23.676±20.95*
    CPFR L·min−1181.86±117.62337.33±105.22 #
    MIP % pred16.63±11.1436.92±26.07***
    MEP % pred19.83±13.2145.67±27.37 #
    • Data are presented as mean±sd unless otherwise stated

    • M: male

    • F: female

    • BMI: body mass index

    • VC: vital capacity

    • CPFR: cough peak flow rate

    • MIP: inspiratory mouth pressure

    • MEP: expiratory mouth pressure

    • NS: nonsignificant

    • *: p<0.05

    • ***: p<0.001

    • #: p<0.0001

  • Table 2—

    Comparison of baseline data in patients who were dead or alive at 18 months

    DeadAlivep‐value
    Patients n3518
    Age yrs63.6±11.5753.72±12.26**
    Sex M:F27:815:3ns
    Disease duration months30.06±28.9735.29±28.08ns
    Bulbar196ns
    BMI kg·m−223.13±3.8024.97±4.06ns
    VC % pred61.91±21.5780.28±22.08**
    CPFR L·min−1214.89±131.26324.94±116.24**
    MIP % pred20.13±18.4337.83±24.32**
    MEP % pred27.03±21.6842.28±27.66*
    Spikes1212*
    • Data are presented as mean±sd unless otherwise stated

    • M: male

    • F: female

    • BMI: body mass index

    • VC: vital capacity

    • CPFR: cough peak flow rate

    • MIP: inspiratory mouth pressure

    • MEP: expiratory mouth pressure

    • *: p<0.05

    • **: p<0.01

    • NS: nonsignificant

  • Table 3—

    Cox's proportional hazards model for survival

    Hazard ratiop‐value95% CI
    Spikes0.990.980.30–3.24
    Age1.040.041.00–1.08
    Sex0.850.750.30–2.40
    Peak Flow1.000.640.99–1.00
    Mean inspiratory pressure %0.980.330.95–1.02
    VC %0.980.150.96–1.01
    • CI: confidence interval

    • VC: vital capacity

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Relationship between supramaximal flow during cough and mortality in motor neurone disease
M.B. Chaudri, C. Liu, R. Hubbard, D. Jefferson, W.J. Kinnear
European Respiratory Journal Mar 2002, 19 (3) 434-438; DOI: 10.1183/09031936.02.00082702

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Relationship between supramaximal flow during cough and mortality in motor neurone disease
M.B. Chaudri, C. Liu, R. Hubbard, D. Jefferson, W.J. Kinnear
European Respiratory Journal Mar 2002, 19 (3) 434-438; DOI: 10.1183/09031936.02.00082702
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