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. 2024 Jan;19(1):99-106.
doi: 10.1007/s11739-023-03446-x. Epub 2023 Oct 27.

Diagnostic delay in symptomatic uncomplicated diverticular disease: an Italian tertiary referral centre study

Giovanni Santacroce #  1   2 , Marco Vincenzo Lenti #  1   2 , Giulia Maria Abruzzese  1   2 , Giacomo Alunno  1   2 , Francesco Di Terlizzi  1   2 , Carmine Frenna  1   2 , Antonella Gentile  1   2 , Mario Andrea Latorre  1   2 , Clarissa Petrucci  1   2 , Damiano Ruggeri  1   2 , Simone Soriano  1   2 , Nicola Aronico  2 , Carlo Maria Rossi  1   2 , Annalisa De Silvestri  3 , Gino Roberto Corazza  1   2 , Antonio Di Sabatino  4   5
Affiliations

Diagnostic delay in symptomatic uncomplicated diverticular disease: an Italian tertiary referral centre study

Giovanni Santacroce et al. Intern Emerg Med. 2024 Jan.

Abstract

The magnitude of the diagnostic delay of symptomatic uncomplicated diverticular disease (SUDD) is unknown; we aimed to evaluate SUDD diagnostic delay and its risk factors. SUDD patients diagnosed at a tertiary referral centre were retrospectively enrolled (2010-2022). Demographic and clinical data were retrieved. Overall, patient-, and physician-dependant diagnostic delays were assessed. Univariate and multivariate analyses were fitted to identify risk factors for diagnostic delay. Overall, 70 SUDD patients (median age 65 years, IQR 52-74; F:M ratio = 1.6:1) were assessed. The median overall diagnostic delay was 7 months (IQR 2-24), patient-dependant delay was 3 months (IQR 0-15), and physician-dependant delay was 1 month (IQR 0-6). Further, 25% of patients were misdiagnosed with irritable bowel syndrome (IBS). At multivariate analysis, previous misdiagnosis was a significant risk factor for overall and physician-dependant diagnostic delay (OR 9.99, p = 0.01, and OR 6.46, p = 0.02, respectively). Also, a high educational level (> 13 years) was associated with a greater overall diagnostic delay (OR 8.74 p = 0.02), while previous abdominal surgery was significantly associated to reduced physician-dependant diagnostic delay (OR 0.19 p = 0.04). To conclude, SUDD may be diagnosed late, IBS being the most frequent misdiagnosis. Timely diagnosis is crucial to tackle the burden of SUDD on patients and healthcare.

Keywords: Diverticular disease; Irritable bowel syndrome; Misdiagnosis; Patient education.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Flow-chart of patient enrolment and inclusion process. The figure illustrates the process of retrospective patient enrolment and inclusion in the study. Patients were excluded if they did not meet SUDD diagnostic criteria (symptoms + evidence of diverticula on imaging), had not been clinically evaluated since 2018, and did not participate in the May 2023 follow-up calls. Created with “Biorender.com”. SUDD, symptomatic uncomplicated diverticular disease
Fig. 2
Fig. 2
Diagnostic delay in symptomatic uncomplicated diverticular disease. The overall, patient-dependant and physician-dependant diagnostic delay in 70 patients with symptomatic uncomplicated diverticular disease is schematically represented. Values are expressed as median and interquartile range. Misdiagnosis are reported. Created with “Biorender.com”. IBD, inflammatory bowel disease; IBS, irritable bowel syndrome; SUDD, symptomatic uncomplicated diverticular disease
See this image and copyright information in PMC

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