Karadeniz Technical University, School of Medicine, Department of Chest Diseases, Trabzon, Turkey.
Ups J Med Sci. 2011 Mar;116(1):72-6. doi: 10.3109/03009734.2010.530701. Epub 2010 Nov 11.
In pulmonary thromboembolism (PE), delay to diagnosis is very common. In this study, we examined the role of patients and the socio-demographic characteristics in delayed diagnosis of PE.
We evaluated 156 PE patients for the dates of symptom onset, the dates of first visit to a health institution and diagnosis, signs and symptoms, and the socio-demographic characteristics. Delays were analyzed using the Mann-Whitney U test, and the predictors were analyzed using logistic regression analysis.
Of the patients, 60.3% visited a health institution within the first day of the symptoms. Mean time from symptoms to the first admission to a health institution (patient delay) was 2.04 ± 3.89 days (median 0 day, range 0-30). Current smoking, a high level of education, and co-morbidity were associated with longer patient delays. The time interval from first symptom to the diagnosis (total delay) was 7.93 ± 10.05 (median 4 days, range 0-45) days. While hypotension, syncope, and previous surgery/trauma were significantly associated with a shorter total delay, a previous visit to any health institution was associated with longer total delay.
In conclusion, although some socio-demographic characteristics of patients such as smoking, educational status, and co-morbid diseases were found to be associated with delayed visit to any health institution, our results showed that physician or health system delays were more prominent in delayed diagnosis of PE.
在肺血栓栓塞症(PE)中,诊断延迟非常常见。在这项研究中,我们研究了患者和社会人口学特征在 PE 诊断延迟中的作用。
我们评估了 156 例 PE 患者的症状发作日期、首次就诊日期和诊断日期、体征和症状以及社会人口学特征。使用 Mann-Whitney U 检验分析延迟,使用逻辑回归分析分析预测因素。
在患者中,60.3%在症状出现的第一天就诊于医疗机构。从症状出现到首次就诊于医疗机构的时间(患者延迟)的平均值为 2.04 ± 3.89 天(中位数 0 天,范围 0-30)。当前吸烟、较高的教育水平和合并症与较长的患者延迟相关。从首次症状出现到诊断的时间间隔(总延迟)为 7.93 ± 10.05 天(中位数 4 天,范围 0-45)。虽然低血压、晕厥和既往手术/创伤与总延迟时间缩短显著相关,但以往就诊于任何医疗机构与总延迟时间延长相关。
总之,尽管患者的一些社会人口学特征,如吸烟、教育状况和合并症与就诊于任何医疗机构的延迟有关,但我们的结果表明,医生或卫生系统的延迟在 PE 的诊断延迟中更为突出。