Indian Real-World Data on Acute Cough Evaluation Through Cough Sounds and Auscultation Findings and Its Complications

Introduction The evaluation of acute cough in primary care settings remains inconsistent, and cough sounds are seldom used for evaluation. This retrospective observational study examined how clinicians across different medical specialties utilize cough sounds and auscultations alongside different diagnostic approaches for the evaluation and categorization of acute cough and overall acute cough-related complications. Methods Electronic medical records from 2017 to 2023 for patients with acute cough were analyzed retrospectively across pediatric (<18 years), adult (18-65 years), and elderly (>65 years) age groups. Auscultation patterns, diagnostic investigations, and cough-related complications were analyzed. Results Unspecified cough predominated across all age groups - pediatric: 128,184 (88.22%); adult: 707,788 (78.29%); and elderly: 154,129 (76.48%). The most common auscultatory finding was wheezing reported by pulmonologists (376, 6.73%) in pediatric patients, 2,954 (5.53%) in adults, and 934 (6.45%) in the elderly. Chest X-ray was the primary diagnostic tool across specialties, whereas imaging use was conservative in pediatric populations (3,767, 15.7%), 33,850 (34.9%) in adults, and 7,869 (56.4%) in the elderly. Chest pain emerged as the most predominant complication in 1,631 (6.78%) pediatric patients, 22,906 (23.61%) adults, and 5,095 (36.58%) elderly. Most general practitioners demonstrated nominal use of cough sounds and auscultatory findings for the evaluation of cough, as it is not a regular practice. Conclusion The use of cough sounds and auscultations remains underutilized in practice, especially by general practitioners. Incorporating systematic acoustic analysis, including cough sounds and auscultatory patterns in primary care, could improve acute cough categorization, reduce or better plan diagnostic testing, and enable targeted and prompt treatment. Future research should focus on developing standardized tools and training programs to optimize acute cough management.