El Mouzan Mohammad I, AlSaleem Badr I, Hasosah Mohammed Y, Al-Hussaini Abdulrahman A, Al Anazi Aziz H, Saadah Omar I, Al Sarkhy Ahmed A, Al Mofarreh Mohammad A, Assiri Asaad A
Department of Pediatrics, Division of Gastroenterology and Head, Pediatric IBD Research Group, King Saud University, Riyadh, Kingdom of Saudi Arabia.
Division of Gastroenterology, The Children Hospital, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia.
Saudi J Gastroenterol. 2019 Jul-Aug;25(4):257-261. doi: 10.4103/sjg.SJG_457_18.
BACKGROUND/AIM: Delay in the diagnosis of inflammatory bowel disease (IBD) is associated with complications. Our aim was to describe the pattern and risk factors associated with delay in the diagnosis of IBD in Saudi children.
This was a multicenter study with a retrospective/prospective design. Data on diagnostic delay in children with Crohn's disease (CD) and ulcerative colitis (UC) were retrieved from physician's notes. Multivariate regression analysis was used to assess the risk factors associated with long delay in diagnosis.
There were 240 and 183 Saudi children with CD and UC, respectively. The median delays in diagnosis were 8 and 5 months in CD and UC, respectively, significantly longer in children with CD than UC (P < 0.001). Long diagnostic delays (>75 percentile) were 24 and 8.8 months for CD and UC, respectively. Ileal location was a significant risk factor in CD and the age of onset above 10 years was protective in UC.
Long diagnostic delay in IBD was mainly due to the longer delay in gastroenterologist consultation. Review of the referral system is needed to focus on measures to reduce long delays in diagnosis. The ileal location as a risk factor in CD and age older than 10 years as protective in UC should help recognition and early referral.
背景/目的：炎症性肠病（IBD）诊断延迟与并发症相关。我们的目的是描述沙特儿童IBD诊断延迟的模式及相关危险因素。
这是一项采用回顾性/前瞻性设计的多中心研究。从医生记录中获取克罗恩病（CD）和溃疡性结肠炎（UC）患儿的诊断延迟数据。采用多变量回归分析评估与诊断长期延迟相关的危险因素。
分别有240例和183例沙特CD和UC患儿。CD和UC的诊断中位延迟分别为8个月和5个月，CD患儿的诊断延迟显著长于UC患儿（P<0.001）。CD和UC的诊断长期延迟（>第75百分位数）分别为24个月和8.8个月。回肠部位是CD的一个显著危险因素，发病年龄大于10岁对UC有保护作用。
IBD诊断长期延迟主要是由于胃肠病学家会诊延迟较长。需要对转诊系统进行审查，以关注减少诊断长期延迟的措施。回肠部位作为CD的危险因素以及10岁以上年龄对UC的保护作用应有助于识别和早期转诊。
