[Description and study of risk factors for the diagnostic delay of pediatric inflammatory bowel disease]

Abstract

Introduction: Diagnostic delay of inflammatory bowel disease in children might be responsible for complications and a poor response to treatment. The study of diagnostic delay and its determining factors may help implement corrective measures and improve the prognosis of the disease.

Patients and methods: A retrospective study of the information collected from primary care medical records and that from the pediatric gastroenterology service at a tertiary hospital between 2000 and 2012 was carried out on 53 patients: 31 with Crohn's disease, 19 with ulcerative colitis, and 3 with unclassified pediatric inflammatory bowel disease. The main response variable was the interval from the first physician-patient contact to diagnosis.

Results: The median time to diagnosis was 12 weeks (interquartile range 5-24). However for 26.3% of the ulcerative colitis cases and 25.8% of the Crohn's disease cases, the interval was longer than 1 year. There was a more marked delay trend in Crohn's disease cases, but it was not statistically significant. None of the evaluated risk factors was associated with a relevant diagnostic delay, although it tended to be longer in younger children.

Conclusions: Whereas the median delay for pediatric inflammatory bowel disease seems to be acceptable, the diagnostic time spans are considerable for a large proportion of children with heterogeneous clinical characteristics. Further research into lost diagnostic opportunities needs to be carried out.

Keywords: Atención primaria; Diagnostic delay; Enfermedad inflamatoria intestinal; Inflammatory bowel disease; Primary care; Retraso diagnóstico.