Li Yuan, Ren Jianan, Wang Gefei, Gu Guosheng, Wu Xiuwen, Ren Huajian, Hong Zhiwu, Hu Dong, Wu Qin, Li Guanwei, Liu Song, Anjum Nadeem, Li Jieshou
Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
Dig Liver Dis. 2015 Jul;47(7):544-8. doi: 10.1016/j.dld.2015.03.004. Epub 2015 Mar 14.
Diagnostic delay of Crohn's disease presents a challenge, and may increase the abdominal surgery rate. There have been no reports regarding diagnostic delay in Chinese patients.
We aimed to evaluate the impact of diagnostic delay on outcomes of Chinese Crohn's disease patients, and identify potential risk factors for the delay.
Altogether, 343 Crohn's disease patients from our hospital were retrospectively included. We assessed the effects of diagnostic delay on the outcomes, and identified the underlying risk factors.
Diagnostic interval was defined as the interval between the first symptoms and the diagnosis of Crohn's disease. Diagnostic delay was defined according to the time interval in which the 76th to 100th percentiles of patients were diagnosed. The rates of subsequent surgery for diagnostic-delay and non-diagnostic-delay patients were 84.7% and 62.4%, respectively (odds ratio=1.108, P<0.0001). We found statistical differences between the two groups regarding age >40 years at diagnosis (35.3% versus 18.2%, P=0.004), basic educational level (48.2% versus 30.6%, P=0.005), and no family history of Crohn's disease (0 versus 1.6%, P=0.045).
Diagnostic delay of Crohn's disease was significantly associated with increased rates of intestinal surgery. Risk factors for diagnostic delay were age >40 years at diagnosis, basic educational level, and no family history of Crohn's disease.
克罗恩病的诊断延迟是一项挑战，且可能会提高腹部手术率。尚无关于中国患者诊断延迟情况的报告。
我们旨在评估诊断延迟对中国克罗恩病患者预后的影响，并确定延迟的潜在风险因素。
本研究回顾性纳入了我院的343例克罗恩病患者。我们评估了诊断延迟对预后的影响，并确定了潜在的风险因素。
诊断间隔定义为首次出现症状至克罗恩病确诊之间的时间间隔。诊断延迟根据患者诊断时间处于第76至第100百分位数的时间间隔来定义。诊断延迟组和非诊断延迟组后续手术率分别为84.7%和62.4%（优势比=1.108，P<0.0001）。我们发现两组在以下方面存在统计学差异：诊断时年龄>40岁（35.3%对18.2%，P=0.004）、基础教育水平（48.2%对30.6%，P=0.005）以及无克罗恩病家族史（0对1.6%，P=0.045）。
克罗恩病的诊断延迟与肠道手术率增加显著相关。诊断延迟的风险因素为诊断时年龄>40岁、基础教育水平以及无克罗恩病家族史。
