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诊断延迟的症状不复杂的分支管疾病:一个意大利的第三级转诊中心研究研究
Giovanni Santacroce1,2, Marco Vincenzo Lenti1,2, Giulia Maria Abruzzese1,2
1Department of Internal Medicine and Medical Therapeutics, University of Pavia, Pavia, Italy.
Internal and emergency medicine
|October 27, 2023
概括
症状无并发性分歧性疾病 (SUDD) 的诊断延迟很大,通常超过七个月. 以前的错误诊断和高等教育水平增加了这种延迟,影响了患者的护理.
科学领域:
- 胃肠病学 胃肠病学
- 临床医学 临床医学
- 流行病学 流行病学
背景情况:
- 症状不复杂的分歧性疾病 (SUDD) 诊断可能会延迟,但其程度和促成因素尚未确定.
- 了解诊断延迟对于改善患者的治疗结果和医疗资源分配至关重要.
研究的目的:
- 评估SUDD患者的诊断延迟,并确定相关的风险因素.
- 确定患者和医生相关因素对SUDD诊断时间表的影响.
主要方法:
- 70名在2010-2022年期间在第三级推中心诊断的SUDD患者的回顾性分析.
- 评估整体,患者依赖和医生依赖的诊断延迟.
- 单变量和多变量分析以确定诊断延迟的风险因素,包括以前的错误诊断和教育水平.
主要成果:
- 超长症候群的总体诊断延迟的中位数为7个月,患者依赖的延迟为3个月,医生依赖的延迟为1个月.
- 刺激性肠综合征 (IBS) 是最常见的误诊,影响了25%的患者.
- 以前的错误诊断显著增加了整体和医生依赖的延迟 (分别为OR 9.99和6.46). 高等教育 (>13年) 与较长的整体延迟相关 (OR 8.74),而之前的腹部手术减少了医生依赖的延迟 (OR 0.19).
结论:
- SUDD经常被诊断为晚期,而IBS是一个常见的初始误诊.
- 以前的错误诊断和更高的教育程度是延迟SUD诊断的重要风险因素.
- 及时诊断SUDD对于减轻其对患者和医疗保健系统的影响至关重要.
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