Systematic evaluation of risk factors for diagnostic delay in inflammatory bowel disease
Systematic evaluation of risk factors for diagnostic delay in inflammatory bowel disease
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DOI：
10.1002/ibd.21719
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发表时间：
2012-03-01
影响因子：
4.9
通讯作者：
Schoepfer, Alain M.
中科院分区：
文献类型：
--
作者：
Vavricka, Stephan R.;Spigaglia, Sabrina M.;Schoepfer, Alain M.
背景：炎症性肠病(IBD)包括克罗恩病(CD)和溃疡性结肠炎(UC)，由于症状不特异和检测准确性有限，诊断仍然存在困难。我们的目的是确定诊断延迟(从首次症状到IBD诊断的时间)并确定相关的危险因素。方法：对来自瑞士IBD队列研究(SIBDC)的1591例IBD患者(932例CD，625例DC，34例不明原因结肠炎)进行评估。SIBDC通过医生和患者问卷从瑞士各地的医院和私人诊所收集了1131名患者的大样本数据。结果：CD患者的诊断延迟显著长于DC患者(中位数为9个月，而DC患者为4个月，P<；0.001)。75%的CD患者在24个月内确诊，而DC患者为12个月，IC患者为6个月。多因素Logistic回归分析显示年龄为24个月)。在DC患者中，非类固醇抗炎药的摄入(OR1.75，P=0.093)和男性(OR0.59，P=0.079)与较长的诊断延迟(>；12个月)相关。结论：虽然CD、DC和IC的诊断延迟的中位数似乎可以接受，但相当一部分CD患者存在较长的延迟。需要做更多的公众宣传工作，以减少这一目标人群中的患者和医生延误。
Background: The diagnosis of inflammatory bowel disease (IBD), comprising Crohn's disease (CD) and ulcerative colitis (UC), continues to present difficulties due to unspecific symptoms and limited test accuracies. We aimed to determine the diagnostic delay (time from first symptoms to IBD diagnosis) and to identify associated risk factors.Methods: A total of 1591 IBD patients (932 CD, 625 DC, 34 indeterminate colitis) from the Swiss IBD cohort study (SIBDCS) were evaluated. The SIBDCS collects data on a large sample of 1131) patients from hospitals and private practice across Switzerland through physician and patient questionnaires. The primary outcome measure was diagnostic delay.Results: Diagnostic delay in CD patients was significantly longer compared to DC patients (median 9 versus 4 months, P < 0.001). Seventy-five percent of CD patients were diagnosed within 24 months compared to 12 months for DC and 6 months for IC patients. Multivariate logistic regression identified age 24 months). In DC patients, nonsteroidal antiinflammatory drug (NSAID intake (OR 1.75, P = 0.093) and male gender (OR 0.59, P = 0.079) were associated with long diagnostic delay (>12 months).Conclusions: Whereas the median delay for diagnosing CD, DC, and IC seems to be acceptable, there exists a long delay in a considerable proportion of CD patients. More public awareness work needs to be done in order to reduce patient and doctor delays in this target population.