Spanish Pediatric Inflammatory Bowel Disease Diagnostic Delay Registry: SPIDER Study From Sociedad Espanola de Gastroenterologia, Hepatologia y Nutricion Pediatrica
Por:
Jiménez Treviño S, Pujol G, Martín-Masot R, Rodríguez Martínez A, Segarra Cantón O, Peña Quintana L, Armas Ramos H, Eizaguirre Arocena FJ, Barrio Torres J, García Burriel JI, Ortigosa Castillo L, Donat Aliaga E, Crujeiras Martínez V, Barros García P, Botija Arcos G, Bartolomé Porro JM, Juste Ruiz M, Ochoa Sangrador C, García Casales Z, Galicia Poblet G, Oliver Goicolea P, Lorenzo Garrido H, García Romero R, La Orden Izquierdo E, Pérez Solis D, Navas-López VM, Díaz Martin JJ and Martín-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:
Jiménez Treviño S:
Pediatrics Oviedo, Hospital Universitario Central de Asturias, Asturias, Spain
Pujol G:
Unit for the Comprehensive Care of Paediatric Inflammatory Bowel Disease, Hospital Sant Joan de Deu, Barcelona, Spain
Martín-Masot R:
Pediatric Gastroenterology and Nutrition Unit, Hospital Regional Universitario de Málaga, Málaga, Spain
Rodríguez Martínez A:
Pediatric Gastroenterology and Nutrition Unit, Hospital Universitario Virgen del Rocío, Sevilla, Spain
Segarra Cantón O:
Pediatric Gastroenterology and Nutrition Unit, Hospital Vall d'Hebrón, Barcelona, Spain
Peña Quintana L:
Pediatric Gastroenterology and Nutrition Unit, Hospital Universitario Materno Infantil de Canarias, Las Palmas Gran Canaria, Spain
Armas Ramos H:
Pediatric Gastroenterology and Nutrition Unit, Hospital Universitario de Canarias, La Laguna, Spain
Eizaguirre Arocena FJ:
Pediatric Gastroenterology and Nutrition Unit, Hospital Universitario de Donostia, San Sebastián, Spain
Barrio Torres J:
Pediatric Gastroenterology and Nutrition Unit, Hospital Universitario de Fuenlabrada, Fuenlabrada, Spain
García Burriel JI:
Pediatric Gastroenterology and Nutrition Unit, Complexo Hospitalario Universitario de Vigo, Vigo, Spain
Ortigosa Castillo L:
Pediatric Gastroenterology and Nutrition Unit, Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain
Donat Aliaga E:
Pediatric Gastroenterology and Nutrition Unit, Hospital La Fe, Valencia, Spain
Crujeiras Martínez V:
Pediatric Gastroenterology and Nutrition Unit, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
Barros García P:
Pediatric Gastroenterology and Nutrition Unit, Hospital San Pedro de Alcántara, Cáceres, Spain
Botija Arcos G:
Pediatric Gastroenterology and Nutrition Unit, San Rafael Hospital, Madrid, Spain
Bartolomé Porro JM:
Pediatric Gastroenterology and Nutrition Unit, Hospital Rio Carrion, Palencia, Spain
Juste Ruiz M:
Pediatric Gastroenterology and Nutrition Unit, Hospital Universitari San Juan de Alicante, Sant Joan d'Alacant, Spain
Ochoa Sangrador C:
Pediatric Gastroenterology and Nutrition Unit, Hospital Virgen de la Concha, Zamora, Spain
García Casales Z:
Pediatric Gastroenterology and Nutrition Unit, Hospital Universitario Araba Sede Txagorritxu, Vitoria-Gasteiz, Spain
Galicia Poblet G:
Pediatric Gastroenterology and Nutrition Unit, Hospital General Universitario de Guadalajara, Guadalajara, Spain
Oliver Goicolea P:
Pediatric Gastroenterology and Nutrition Unit, Hospital de Mendaro, Mendaro, Spain
Lorenzo Garrido H:
Pediatric Gastroenterology and Nutrition Unit, Hospital de Basurto, Basurto, Spain
García Romero R:
Pediatric Gastroenterology and Nutrition Unit, Hospital Universitario Miguel Servet, Zaragoza, Spain
La Orden Izquierdo E:
Pediatric Gastroenterology and Nutrition Unit, Hospital Universitario Infanta Elena, Valdemoro, Spain
Pérez Solis D:
Pediatric Gastroenterology and Nutrition Unit, Hospital San Agustín de Avilés, Avilés, Spain
Navas-López VM:
Pediatric Gastroenterology and Nutrition Unit, Hospital Regional Universitario de Málaga, Málaga, Spain
Díaz Martin JJ:
Pediatrics Oviedo, Hospital Universitario Central de Asturias, Asturias, Spain
Martín-de-Carpi J:
Unit for the Comprehensive Care of Paediatric Inflammatory Bowel Disease, Hospital Sant Joan de Deu, Barcelona, Spain
Green Published, gold
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