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与哥伦比亚患者的中轴型脊柱关节炎的诊断延迟相关的因素。

Factors Associated With Diagnostic Delay of Axial Spondyloarthritis in Colombian Patients.

机构信息

From the Master of Science in Epidemiology, Universidad del Rosario-Universidad CES.

Research Institute, Fundación Universitaria de Ciencias de la Salud.

出版信息

J Clin Rheumatol. 2022 Apr 1;28(3):126-131. doi: 10.1097/RHU.0000000000001814.

Abstract

BACKGROUND/OBJECTIVE: The diagnostic delay of axial spondyloarthritis (axSpA) is globally reported to be between 3 and 11 years. Early diagnosis and treatment have long-term benefits for patients and the health care system. Several international studies have evaluated some factors associated with diagnostic delay, but there are no known studies in the Colombian population. This study assesses the factors associated with diagnostic delay of axSpA in a rheumatology center in Bogota, Colombia.

METHODS

This monocentric analytical cross-sectional study was done in a specialized rheumatology center. Patients who fulfilled the 2009 Assessment of Spondyloarthritis International Society (ASAS) classification criteria for axSpA were included. Information was obtained from medical records and a phone call. Bivariate and multivariate analyses were done to assess the associated factors with diagnostic delay.

RESULTS

One hundred one patients were included, 54 were women (53.5%). The median diagnostic delay was 2 years (interquartile range, 1-7). The bivariate analysis showed that a younger age at diagnosis (p = 0.042) and previous diagnosis of lumbar degenerative disease (p = 0.029) were associated with a longer diagnostic delay. The logistical regression showed that previous lumbar degenerative disc disease (odds ratio, 2.8; 95% confidence interval, 1.09-7.53) and fibromyalgia (odds ratio, 4.0; 95% confidence interval, 1.2-13.1) diagnosis were both associated with a longer diagnostic delay.

CONCLUSIONS

Factors associated with a longer diagnostic delay were previous diagnosis of lumbar degenerative disc disease and fibromyalgia. Additional studies are needed so that the reasons for diagnostic delay are understood and early diagnosis and management of axSpA are enabled.

摘要

背景/目的:全球范围内,轴性脊柱关节炎(axSpA)的诊断延误时间报告为 3 至 11 年。早期诊断和治疗对患者和医疗保健系统都有长期益处。多项国际研究评估了与诊断延误相关的一些因素,但在哥伦比亚人群中尚无已知的研究。本研究评估了哥伦比亚波哥大一家风湿病中心 axSpA 诊断延误的相关因素。

方法

这是一项单中心分析性横断面研究,在一家专门的风湿病中心进行。纳入符合 2009 年评估强直性脊柱炎国际学会(ASAS)axSpA 分类标准的患者。从病历和电话中获取信息。进行了单变量和多变量分析,以评估与诊断延误相关的因素。

结果

共纳入 101 例患者,其中 54 例为女性(53.5%)。中位诊断延误时间为 2 年(四分位间距,1-7)。单变量分析显示,诊断时年龄较小(p=0.042)和先前诊断为腰椎退行性疾病(p=0.029)与诊断延误时间较长相关。逻辑回归显示,先前诊断为腰椎退行性椎间盘疾病(比值比,2.8;95%置信区间,1.09-7.53)和纤维肌痛(比值比,4.0;95%置信区间,1.2-13.1)均与诊断延误时间较长相关。

结论

与诊断延误时间较长相关的因素为先前诊断为腰椎退行性椎间盘疾病和纤维肌痛。需要进一步研究,以了解诊断延误的原因,并实现 axSpA 的早期诊断和管理。

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