INTRODUCTION The COuGH RefluX score has been validated to predict likelihood of gastroesophageal reflux disease (GERD) in patients with laryngopharyngeal symptoms (LPS) using parameters of Cough, Overweight, Globus, Hiatal Hernia, Regurgitation, and male seX. This study aimed to assess the real-world value of the COuGH RefluX score in predicting proton pump inhibitor (PPI) response in LPS patients. METHODS Patients with LPS for >3 months were prospectively enrolled, and assessed using the Reflux Symptom Index (RSI) and 24-hour impedance-pH monitoring. Based on COuGH RefluX scores, patients were designated unlikely GERD (≤2.5), inconclusive GERD (3.0-4.5), and likely GERD (≥5.0). PPI response was defined as a 50% reduction in RSI. RESULTS Among 196 participants (mean age 47.8), 121 were unlikely, 60 were inconclusive, and 15 were likely to have GERD. Patients unlikely to have GERD had higher MNBI, lower hiatal hernia prevalence, and fewer confirmed GERD cases compared to inconclusive and likely GERD groups (P <0.05). Symptom severity and AET were similar across groups (P >0.05). PPI response rates were 12.4%, 45.0%, and 73.3% across the groups (P <0.001). Multivariate logistic regression showed COuGH RefluX scores and lower MNBI as independent predictors of PPI responsiveness (scores 3.0-4.5, OR =4.190, P =0.001; scores ≥5.0, OR =15.772, P <0.001; MNBI, OR =0.915, P =0.001). DISCUSSION The COuGH RefluX score is effective in predicting GERD and guiding PPI use in LPS patients without esophagitis. The score can ensure appropriate PPI use and targeted testing during initial LPS patient encounters.

中文翻译：

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COuGH RefluX 评分在咽咽症状患者中的实际应用：预测 GERD 和 PPI 反应的真实世界评估。


引言 COuGH RefluX 评分已被验证为使用咳嗽、超重、癔球症、食管裂孔疝、反流和男性 参数预测喉咽症状 （LPS） 患者发生胃食管反流病 （GERD） 的可能性。本研究旨在评估 COuGH RefluX 评分在预测 LPS 患者质子泵抑制剂 （PPI） 反应中的真实价值。方法 前瞻性纳入 >3 个月的 LPS 患者，并使用反流症状指数 （RSI） 和 24 小时阻抗 pH 监测进行评估。根据 COuGH RefluX 评分，患者被指定为不太可能的 GERD （≤2.5） 、不确定的 GERD （3.0-4.5） 和可能的 GERD （≥5.0）。PPI 反应定义为 RSI 降低 50%。结果 在 196 名参与者 （平均年龄 47.8） 中，121 名不太可能，60 名不确定，15 名可能患有 GERD。与不确定和可能的 GERD 组相比，不太可能患有 GERD 的患者具有较高的 MNBI、较低的食管裂孔疝患病率和较少的确诊 GERD 病例 （P <0.05）。各组症状严重程度和 AET 相似 （P >0.05）。各组 PPI 反应率分别为 12.4% 、 45.0% 和 73.3% （P <0.001）。多因素 logistic 回归显示 COuGH RefluX 评分和较低的 MNBI 是 PPI 反应性的独立预测因子 （评分 3.0-4.5，OR =4.190，P =0.001;评分 ≥5.0，OR =15.772，P <0.001;MNBI，OR =0.915，P =0.001）。讨论 COuGH RefluX 评分可有效预测 GERD 和指导无食管炎的 LPS 患者的 PPI 使用。该评分可以确保在初次 LPS 患者就诊期间适当使用 PPI 和进行有针对性的测试。