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多发性硬化症在低流行国家的延迟诊断。

Delayed diagnosis of multiple sclerosis in a low prevalence country.

机构信息

MS Center, Department of Neurology, Multiple Sclerosis Research Group - National University of Colombia, Bogotá, Colombia.

MS Center, Department of Nursing, Multiple Sclerosis Research Group - National University of Colombia, Bogotá, Colombia.

出版信息

Neurol Res. 2021 Jul;43(7):521-527. doi: 10.1080/01616412.2020.1866374. Epub 2020 Dec 23.

DOI:10.1080/01616412.2020.1866374
PMID:33357115
Abstract

: Early diagnosis and treatment of multiple sclerosis (MS) is crucial to avoid future disability. The factors that influence diagnostic delay in low prevalence settings have been poorly studied.: To evaluate the factors associated with a delayed diagnosis of MS after the symptomatic onset.: Clinical records of confirmed MS patients were reviewed. Diagnostic delay was calculated by subtracting the date of onset from the date of diagnosis and categorized as early and delayed, when below and above than 1 year. Logistic regression was performed to evaluate the likelihood of a delayed diagnosis according to age at first symptom, gender, type of the first symptom, progressive vs relapsing onset, diagnostic criteria prevailing at the time of symptom onset, comorbidities, and family history of MS.: Data of 525 (95.6%) from a cohort of 549 patients were analyzed. About 69.1% were women. The mean age was 43.2 years. About 86.3% had relapsing-remitting MS. The mean overall diagnostic delay was 3.07 years. About 45.7% of the patients had a delayed diagnosis, and it was dependent on the symptom and the diagnostic criteria prevailing at the onset. Multivariate logistic regression showed onset during the Schumacher (OR = 10.03 [95%CI 1.30-77.1], p = 0.027) and Poser (OR = 4.26 [95%CI 1.25-15.15], p = 0.021) years were associated with delayed MS diagnosis.: MS onset before the McDonald diagnostic criteria era is associated with delayed diagnosis.

摘要

早期诊断和治疗多发性硬化症(MS)对于避免未来残疾至关重要。在低流行地区,影响诊断延迟的因素研究甚少。评估症状出现后 MS 诊断延迟的相关因素。回顾确诊 MS 患者的临床记录。通过从发病日期中减去诊断日期来计算诊断延迟,并分为早期和晚期,分别为 1 年以下和 1 年以上。进行逻辑回归分析,根据首发症状时的年龄、性别、首发症状类型、进行性或复发性发病、症状发作时流行的诊断标准、合并症和 MS 家族史,评估诊断延迟的可能性。对来自 549 例患者队列的 525 例(95.6%)数据进行分析。约 69.1%为女性,平均年龄为 43.2 岁。约 86.3%为复发缓解型 MS。总的平均诊断延迟为 3.07 年。约 45.7%的患者存在诊断延迟,这取决于首发症状和当时流行的诊断标准。多变量逻辑回归显示,在 Schumacher 年(OR=10.03[95%CI 1.30-77.1],p=0.027)和 Poser 年(OR=4.26[95%CI 1.25-15.15],p=0.021)发病与 MS 诊断延迟相关。在 McDonald 诊断标准时代之前发病与 MS 诊断延迟有关。

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