Z Gastroenterol 2017; 55(05): e28-e56
DOI: 10.1055/s-0037-1603373
CED
Georg Thieme Verlag KG Stuttgart · New York

Diagnostic delay in patients with inflammatory bowel disease – a study of the Austrian IBD study group (ATISG)

G Novacek
1   Medizinische Universität Wien, Univ.-Klinik für Innere Medizin III, Wien, Austria
,
H Gröchenig
2   Krankenhaus Barmherzige Brüder, Innere Medizin, St. Veit an der Glan, Austria
,
T Haas
3   Darmpraxis, Salzburg, Austria
,
H Wenzl
4   Medizinische Universität Graz, Abteilung für Gastroenterologie und Hepatologie, Graz, Austria
,
P Steiner
5   Klinikum Wels-Grieskirchen, Abteilung für Innere Medizin I, Wels, Austria
,
R Koch
6   Medizinische Universität Innsbruck, Innere Medizin I, Innsbruck, Austria
,
T Feichtenschlager
7   Krankenanstalt Rudolfstiftung, Innere Medizin IV, Wien, Austria
,
G Eckhardt
8   Landeskrankenhaus Oberpullendorf, Oberpullendorf, Austria
,
A Mayer
9   Universitätsklinikum St. Pölten, 2. Medzinische Abteilung, St. Pölten, Austria
,
A Kirchgatterer
10   Klinikum Wels-Grieskirchen, Abteilung für Innere Medizin V, Grieskirchen, Austria
,
O Ludwiczek
11   Landeskrankenhaus Hall in Tirol, Innere Medizin, Hall in Tirol, Austria
,
R Platzer
12   Landeskrankenhaus Wiener Neustadt, Abteilung für Innere Medizin I, Wiener Neustadt, Austria
,
P Papay
13   Hartmannspital Wien, Innere Medizin, Wien, Austria
,
J Gartner
14   Hanusch Krankenhaus, Innere Medizin, Wien, Austria
,
H Fuchssteiner
15   Krankenhaus Elisabethinen Linz, Innere Medizin IV, Linz, Austria
,
W Miehsler
16   Krankenhaus Barmherzige Brüder, Innere Medizin, Salzburg, Austria
,
P Peters
17   Landeskrankenhaus Feldkirch, Abteilung für Innere Medizin I, Feldkirch, Austria
,
G Reicht
18   Krankenhaus Barmherzige Brüder, Innere Medizin, Graz, Austria
,
H Vogelsang
1   Medizinische Universität Wien, Univ.-Klinik für Innere Medizin III, Wien, Austria
,
C Dejaco
1   Medizinische Universität Wien, Univ.-Klinik für Innere Medizin III, Wien, Austria
,
T Waldhör
19   Medizinische Universität Wien, Abteilung für Epidemiologie, Wien, Austria
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Publikationsverlauf

Publikationsdatum:
16. Mai 2017 (online)

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Background:

Diagnostic delay seems to be common in inflammatory bowel disease (IBD), especially in Crohn's disease (CD). We sought to investigate the diagnostic delay in Austrian IBD patients and to identify associated risk factors as well as the impact of delayed diagnosis on the risk of intestinal surgery in CD.

Methods:

In a multicentre cohort study adult patients with IBD (CD, ulcerative colitis UC, inflammatory bowel disease unclassified IBDU) attending 18 Austrian outpatient clinics were recruited between May 2014 and July 2015 to complete a multi-item questionnaire, which recorded medical and socioeconomic characteristics. Study outcome was the diagnostic delay defined as the time period between symptom onset to diagnosis of IBD. A multivariable proportional hazard regressions model based on interval censored latency times was calculated.

Results:

1217 patients (CD 779, UC 400, IBD 21, missing 17; females 615) with a median age of 40 years (interquartile range (IQR) 31 – 52 years) and a median disease duration of 10 years (IQR 4 – 18 years) were analysed. The median diagnostic delay was 0.53 years (IQR 0.20 – 1.92 years) in CD and 0.28 years (IQR 0.11 – 0.86 years) in UC, respectively (p < 0.001). In the multivariable regression analysis patients with CD had a significantly longer diagnostic delay than patients with UC (HR 1.56; 95% CI 1.34 – 1.82; p < 0.0001) and a quadratic effect of age leading to higher risk of delayed diagnosis in older patients (p < 0.0001) was found. Diagnostic delay did not differ significantly between patients with intestinal CD-related surgery (53% of all CD patients) and those without surgery. However, in the Kaplan-Meier curve for the probability of being diagnosed after symptom onset a trend of a difference between both groups was seen after 10 months (p = 0.13).

Discussion:

Diagnostic delay was longer in CD than in UC patients and was associated with older age at diagnosis.