A Prospective Cohort Study on Risk Factors for Postoperative Cough in Patients Undergoing Thoracoscopic Lung Resection
Conditions: Lung Cancer
Sponsor: Hematology department of the 920th hospital

 
 
 
 
 A Prospective Cohort Study on Risk Factors for Postoperative Cough in 
Patients Undergoing Thoracoscopic Lung Resection  
 Study Protocol  
 
2024-2-1 
 

Study design  
This study is a prospective observational study and is expected to be carried out in 
a large tertiary hospital.  According to the data of previous years, more than 300 
patients underwent thoracoscopic lung resection in our center every year, and the 
incidence of cough after pneumonectomy was 21.1%-55.8%, and this cohort is 
expected to include 1000 participants for three years. 
Patients with pulmonary nodules on chest CT will be divided into two groups 
based on the presence or absence of cough symptoms on admission. The investigators 
decided whether to include patients in this cohort study strictly based on the inclusion 
and exclusion criteria. The severity of cough, the trajectory of cough change, and the 
physiological and social burden caused by cough will be reflected by the results of 
LCQ-MC, CSS, HARQ, and VAS. The included variables included age, gender, BMI, 
education level, smoking history, alcohol history, preoperative lung function, nodule 
size, preoperative and postoperative blood routine (such as white blood cell count, 
neutrophil count, etc.), blood biochemistry (such as C-reactive protein, PCT, etc.), liver 
and kidney function test results, surgical method, surgical site, operation duration, 
anesthesia method, anesthesia duration, lymph node dissection, pathological results, 
chest tube caliber, number of days of catheterization, use of cough drugs, use of non-
steroidal anti-inflammatory drugs, Number of days in hospital and number of outpatient 
visits due to cough. 
Study Population 
The participants in this study are from the 920th Hospital.  Patients aged 18 years 

or older and less than or equal to 70 years of age who underwent surgery with video-
assisted thoracoscopic pneumonectomy will be included.  The exclusion criteria 
include: 1. Pre-existing cough before surgery (e.g. asthma, taking ACEI Drugs, etc.); 2. 
Distant metastasis of tumor; 3. Combined pregnancy or breastfeeding; 4. Combined 
with other systemic major diseases (such as malignant swelling, chronic liver 
insufficiency, chronic renal insufficiency, etc.); 5. Suffering from mental illness; 6. 
Refusal of follow-up or incomplete clinical information; 7. Poor compliance and other 
groups considered by the investigator not suitable for inclusion.  All included patients 
have to sign an informed consent form and provide demographic information and 
clinical data. 
Observation Parameters and Schedule 
Follow-up 
content 
Follow-up time points 
 
 
 
 
 
 
 
 
 
Baseline 
3  
days 
7 
 days 
11 
days 
15 
days 
30 
days 
90 
days 
180 
 days 
LCQ-MC 
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CSS 
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HARQ 
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○ 
 
 
 
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VAS 
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○ 
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CT of the chest 
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○ 
 
 
 
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Number of 
clinic visits 
 
 
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Cough 
medication use 
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Objectives and outcomes 
This prospective cohort study will describe the incidence of CAP and the trajectory 
change in cough severity in patients with thoracoscopic lung resection.  The primary 
objective of the study is to explore the risk factors for the development of CAP and to 
assess the physical, psychological, social, and life burdens of patients with CAP.  The 
secondary objective is to see if the use of nonsteroidal drugs has an effect on the 
development of CAP.  This study aims to provide preliminary evidence and guidance 
on appropriate treatment of post-pneumonectomy cough and risk factors for persistent 
cough and non-steroidal pharmacotherapy for CAP.