Spanish Pediatric Inflammatory Bowel Disease Diagnostic Delay Registry: SPIDER Study From Sociedad Espanola de Gastroenterologia, Hepatologia y Nutricion Pediatrica
Por:
Trevino, S, Muncunill, G, Martin-Masot, R, Martinez, A, Canton, O, Quintana, L, Ramos, H, Arocena, F, Torres, J, Burriel, J, Castillo, L, Aliaga, E, Martinez, V, Garcia, P, Arcos, G, Porro, J, Ruiz, M, Sangrador, C, Casales, Z, Poblet, G, Goicolea, P, Garrido, H, Romero, R, Izquierdo, E, Solis, D, Navas-Lopez, V, Martin, J and de Carpi, J
Publicada:
15 oct 2020
Ahead of Print:
15 oct 2020
Categoría:
Pediatrics, perinatology and child health
Resumen:
Background and Aims: Diagnostic delay (DD) is especially relevant in children with inflammatory bowel disease, leading to potential complications. We examined the intervals and factors for DD in the pediatric population of Spain.
Methods: We conducted a multicentric prospective study, including 149 pediatric inflammatory bowel disease patients, obtaining clinical, anthropometric, and biochemical data. Time to diagnosis (TD) was divided into several intervals to identify those where the DD was longer and find the variables that prolonged those intervals. Missed opportunities for diagnosis (MODs) were also identified.
Results: Overall TD was 4.4 months (interquartile range [IQR] 2.6-10.4), being significantly higher in Crohn's disease (CD) than in ulcerative colitis (UC) (6.3 [IQR 3.3-12.3] vs. 3 [IQR 1.6-5.6] months, p = 0.0001). Time from the visit to the first physician until referral to a pediatric gastroenterologist was the main contributor to TD (2.4 months [IQR 1.03-7.17] in CD vs. 0.83 months [IQR 0.30-2.50] in UC, p = 0.0001). One hundred and ten patients (78.3%) visited more than one physician (29.9% to 4 or more), and 16.3% visited the same physician more than six times before being assessed by the pediatric gastroenterologist. The number of MODs was significantly higher in CD than that in UC patients: 4 MODs (IQR 2-7) vs. 2 MODs ([IQR 1-5], p = 0.003). Referral by pediatricians from hospital care allowed earlier IBD diagnosis (odds ratio 3.2 [95% confidence interval 1.1-8.9], p = 0.025).
Conclusions: TD and DD were significantly higher in CD than those in UC. IBD patients (especially those with CD) undergo a large number of medical visits until the final diagnosis.
Filiaciones:
Trevino, S:
Hosp Univ Cent Asturias, Pediat Oviedo, Asturias, Spain
Muncunill, G:
Hosp St Joan Deu, Unit Comprehens Care Paediat Inflammatory Bowel D, Barcelona, Spain
Martin-Masot, R:
Hosp Reg Univ Malaga, Pediat Gastroenterol & Nutr Unit, Malaga, Spain
Martinez, A:
Hosp Univ Virgen del Rocio, Pediat Gastroenterol & Nutr Unit, Seville, Spain
Canton, O:
Hosp Valle De Hebron, Pediat Gastroenterol & Nutr Unit, Barcelona, Spain
Quintana, L:
Hosp Univ Materno Infantil Canarias, Pediat Gastroenterol & Nutr Unit, Las Palmas Gran Canaria, Spain
Ramos, H:
Hosp Univ Canaries, Pediat Gastroenterol & Nutr Unit, San Cristobal la Laguna, Spain
Arocena, F:
Hosp Univ Donostia, Pediat Gastroenterol & Nutr Unit, San Sebastian, Spain
Torres, J:
Hosp Univ Fuenlabrada, Pediat Gastroenterol & Nutr Unit, Fuenlabrada, Spain
Burriel, J:
Complexo Hosp Univ Vigo, Pediat Gastroenterol & Nutr Unit, Vigo, Spain
Castillo, L:
Hosp Univ Nuestra Senora Candelaria, Pediat Gastroenterol & Nutr Unit, Santa Cruz De Tenerife, Spain
Aliaga, E:
Hosp La Fe, Pediat Gastroenterol & Nutr Unit, Valencia, Spain
Martinez, V:
Univ Hosp Santiago de Compostela, Pediat Gastroenterol & Nutr Unit, Santiago De Compostela, Spain
Garcia, P:
Hosp San Pedro Alcantara, Pediat Gastroenterol & Nutr Unit, Caceres, Spain
Arcos, G:
San Rafael Hosp, Pediat Gastroenterol & Nutr Unit, Madrid, Spain
Porro, J:
Hosp Rio Carrion, Pediat Gastroenterol & Nutr Unit, Palencia, Spain
:
Hosp Univ San Juan Alicante, Pediat Gastroenterol & Nutr Unit, Sant Joan dAlacant, Spain
Sangrador, C:
Hosp Virgen de la Concha, Pediat Gastroenterol & Nutr Unit, Zamora, Spain
Casales, Z:
Hosp Univ Araba Sede Txagorritxu, Pediat Gastroenterol & Nutr Unit, Vitoria, Spain
Poblet, G:
Hosp Gen Univ Guadalajara, Pediat Gastroenterol & Nutr Unit, Guadalajara, Spain
Goicolea, P:
Hosp Mendaro, Pediat Gastroenterol & Nutr Unit, Mendaro, Spain
Garrido, H:
Hosp Basurto, Pediat Gastroenterol & Nutr Unit, Basurto, Spain
Romero, R:
Hosp Univ Miguel Servet, Pediat Gastroenterol & Nutr Unit, Zaragoza, Spain
Izquierdo, E:
Hosp Univ Infanta Elena, Pediat Gastroenterol & Nutr Unit, Valdemoro, Spain
Solis, D:
San Agustin Aviles, Pediat Gastroenterol & Nutr Unit, Aviles, Spain
Navas-Lopez, V:
Hosp Reg Univ Malaga, Pediat Gastroenterol & Nutr Unit, Malaga, Spain
Martin, J:
Hosp Univ Cent Asturias, Pediat Oviedo, Asturias, Spain
de Carpi, J:
Hosp St Joan Deu, Unit Comprehens Care Paediat Inflammatory Bowel D, Barcelona, Spain
Green Published, gold
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