Diagnostic delay and colectomy risk in pediatric ulcerative colitis

Area of Science:

• Pediatric Gastroenterology
• Inflammatory Bowel Disease Research
• Clinical Prognosis Studies

Background:

• Diagnostic delay in pediatric Inflammatory Bowel Disease (PIBD), particularly pediatric ulcerative colitis (P-UC), is understudied compared to adults.
• P-UC often presents with a more severe disease course than adult ulcerative colitis (UC).

Purpose of the Study:

• To investigate the relationship between diagnostic delay and the risk of colectomy in pediatric ulcerative colitis (P-UC).
• To compare diagnostic delay in P-UC patients who underwent colectomy versus those who did not.

Main Methods:

• Retrospective review of medical records for 106 P-UC patients (<18 years) diagnosed between 2012 and 2018.
• Identification of symptom onset to diagnosis time (diagnostic delay) and colectomy status.
• Analysis of fecal calprotectin levels at diagnosis.

Main Results:

• No statistically significant difference in diagnostic delay between patients who underwent colectomy (C-UC) and those who did not (NC-UC).
• A trend towards shorter diagnostic delay in C-UC patients (median 7.1 weeks) compared to NC-UC patients (median 11.9 weeks).
• Significantly higher fecal calprotectin levels were observed in C-UC patients at diagnosis (p=0.0228).

Conclusions:

• Shorter diagnostic delay in P-UC may correlate with increased disease severity at onset and a more aggressive disease course.
• Elevated fecal calprotectin levels at diagnosis provide biochemical evidence supporting the link between disease severity and colectomy risk in P-UC.