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新诊断中枢神经系统肿瘤患儿的诊断延误

Delays in diagnosis for children with newly diagnosed central nervous system tumors.

作者信息

Coven Scott L, Stanek Joseph R, Hollingsworth Ethan, Finlay Jonathan L

机构信息

The Division of Hematology, Oncology and BMT, Nationwide Children's Hospital, Columbus, Ohio.

Department of Pediatrics, The Ohio State University, Columbus, Ohio.

出版信息

Neurooncol Pract. 2018 Nov;5(4):227-233. doi: 10.1093/nop/npy002. Epub 2018 Mar 9.

Abstract

BACKGROUND

United States studies documenting time interval from symptom onset to definitive diagnosis for childhood central nervous system (CNS) tumors are more than a quarter-century old. The purpose of this study is to establish an accurate and contemporary Ohio baseline of the diagnostic interval for children with newly diagnosed CNS tumors.

METHODS

Medical records were retrospectively reviewed for 301 children with newly diagnosed CNS tumors from January 2004 to August 2015 at Nationwide Children's Hospital. We obtained comprehensive data on 171 patients (56.8%). Records were reviewed for age, gender, tumor type, presenting symptoms, number of health care visits prior to diagnosis, time interval (in months) from onset of symptoms to definitive diagnosis, and any associated genetic syndromes.

RESULTS

Of the 171 patients with newly diagnosed CNS tumors, 25 children (14.6%) had a known cancer predisposition syndrome (all with neurofibromatosis type 1). Among the remaining 146 children, the median and mean time intervals from symptom onset to definitive diagnosis were 42 days and 138 days (range < 1 to 2190 days), respectively.

CONCLUSIONS

We have documented and quantified the contemporary delays in diagnosis of childhood brain tumors in central Ohio to serve as a benchmark for our future planned interventions to reduce the time interval from symptom onset to diagnosis through adaptation of the United Kingdom HeadSmart program throughout the state of Ohio and ultimately throughout the United States.

摘要

背景

美国关于记录儿童中枢神经系统(CNS)肿瘤从症状出现到确诊的时间间隔的研究已有超过四分之一个世纪的历史。本研究的目的是建立俄亥俄州新诊断中枢神经系统肿瘤儿童诊断间隔的准确且当代的基线。

方法

对2004年1月至2015年8月在全国儿童医院新诊断为中枢神经系统肿瘤的301名儿童的病历进行回顾性审查。我们获得了171名患者(56.8%)的全面数据。审查记录包括年龄、性别、肿瘤类型、出现的症状、诊断前的医疗就诊次数、从症状出现到确诊的时间间隔(以月为单位)以及任何相关的遗传综合征。

结果

在171名新诊断为中枢神经系统肿瘤的患者中,25名儿童(14.6%)有已知的癌症易感性综合征(均为1型神经纤维瘤病)。在其余146名儿童中,从症状出现到确诊的中位时间间隔和平均时间间隔分别为42天和138天(范围<1至2190天)。

结论

我们已经记录并量化了俄亥俄州中部儿童脑肿瘤当代的诊断延迟情况,以此作为我们未来计划干预措施的基准,通过在俄亥俄州乃至最终在美国全国采用英国的HeadSmart计划来缩短从症状出现到诊断的时间间隔。

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