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与克罗恩病延迟诊断相关的因素:系统性审查和元分析
Jinping Xie1, Miaofeng Chen1, Wenrui Wang1
1The Research Center of National Drug Policy & Ecosystem, China Pharmaceutical University, Nanjing, 211198, China.
Heliyon
|October 20, 2023
概括
克罗恩氏病 (CD) 的延迟诊断与阴茎CD,吸烟和NSAID使用有关. 对这些因素的患者和提供者进行教育对于及时管理至关重要.
科学领域:
- 胃肠病学 胃肠病学
- 流行病学 流行病学
- 临床医学 临床医学
背景情况:
- 延迟诊断是克罗恩病 (CD) 管理的一个重大障碍.
- 之前的研究发现了导致诊断延迟的因素,但缺乏系统的评估.
研究的目的:
- 系统地评估各种因素对克罗恩病延迟诊断的影响.
- 为提供与CD诊断延迟相关的因素的综合元分析.
主要方法:
- 对2022年4月之前发表的观察性研究进行了PubMed,EMBASE和Web of Science数据库的系统搜索.
- 包括的研究评估了与CD诊断延迟相关的因素;不包括评论,病例报告和评论.
- 质量评估使用了纽卡斯尔-太华尺度,调查了异质性,并评估了道图表的出版偏差.
主要成果:
- 分析了18项研究,包括13个国家的9669例病例.
- 皮层CD (OR=1.46),目前的吸烟 (OR=1.19) 和NSAID使用 (OR=1.34) 与诊断延迟有显著的相关性.
- 没有发现与性别,年龄,结肠直肠镜或腹有显著的关联;漏斗图显示了潜在的出版偏差.
结论:
- 克罗恩病的临床位置,吸烟和NSAID使用被确定为延迟诊断的关键风险因素.
- 建议提高患者和初级保健提供者对这些因素的认识和教育.
- 解决这些因素可能会提高克罗恩病诊断和管理的及时性.
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