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Diagnostic delay of pediatric inflammatory bowel disease in Saudi Arabia
Mohammad I El Mouzan1, Badr I AlSaleem2, Mohammed Y Hasosah3
1Department of Pediatrics, Division of Gastroenterology and Head, Pediatric IBD Research Group, King Saud University, Riyadh, Kingdom of Saudi Arabia.
Insights
Delayed diagnosis of inflammatory bowel disease (IBD) in Saudi children, particularly Crohn
Area of Science:
- Pediatric gastroenterology
- Inflammatory Bowel Disease (IBD) diagnostics
- Epidemiology of IBD in children
Background:
- Delayed diagnosis of Inflammatory Bowel Disease (IBD) is linked to increased complications in children.
- Understanding diagnostic patterns and risk factors is crucial for timely intervention in pediatric IBD cases.
Purpose of the Study:
- To investigate the patterns of diagnostic delay in Saudi children diagnosed with Inflammatory Bowel Disease (IBD).
- To identify significant risk factors associated with delayed diagnosis of Crohn's disease (CD) and ulcerative colitis (UC) in pediatric patients.
Main Methods:
- A multicenter retrospective/prospective study design was employed.
- Data were collected from physician's notes for children diagnosed with Crohn's disease (CD) and ulcerative colitis (UC).
- Multivariate regression analysis was utilized to determine risk factors for prolonged diagnostic delays.
Main Results:
- Median diagnostic delays were 8 months for Crohn's disease (CD) and 5 months for ulcerative colitis (UC), with CD delays being significantly longer.
- Long diagnostic delays (exceeding the 75th percentile) were 24 months for CD and 8.8 months for UC.
- Ileal location was identified as a significant risk factor for diagnostic delay in CD, while age over 10 years at onset was protective for UC.
Conclusions:
- Prolonged diagnostic delays in pediatric Inflammatory Bowel Disease (IBD) are often attributed to delayed gastroenterologist consultations.
- Revising the current referral system is essential to implement strategies for reducing diagnostic delays.
- Recognizing ileal location as a risk factor in CD and older age at onset in UC can aid in earlier recognition and referral.
Background/Aim:
Delay in the diagnosis of inflammatory bowel disease (IBD) is associated with complications. Our aim was to describe the pattern and risk factors associated with delay in the diagnosis of IBD in Saudi children.
Patients And Methods:
This was a multicenter study with a retrospective/prospective design. Data on diagnostic delay in children with Crohn's disease (CD) and ulcerative colitis (UC) were retrieved from physician's notes. Multivariate regression analysis was used to assess the risk factors associated with long delay in diagnosis.
Results:
There were 240 and 183 Saudi children with CD and UC, respectively. The median delays in diagnosis were 8 and 5 months in CD and UC, respectively, significantly longer in children with CD than UC (P < 0.001). Long diagnostic delays (>75th percentile) were 24 and 8.8 months for CD and UC, respectively. Ileal location was a significant risk factor in CD and the age of onset above 10 years was protective in UC.
Conclusions:
Long diagnostic delay in IBD was mainly due to the longer delay in gastroenterologist consultation. Review of the referral system is needed to focus on measures to reduce long delays in diagnosis. The ileal location as a risk factor in CD and age older than 10 years as protective in UC should help recognition and early referral.
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