Yamamoto-Furusho Jesús K, Parra-Holguín Norma N
Inflammatory Bowel Disease Clinic, Department of Gastroenterology, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico.
Gastroenterology and Obesity Service, Médica Sur Hospital, Mexico City, Mexico.
Inflamm Intest Dis. 2021 Dec 6;7(2):72-80. doi: 10.1159/000520522. eCollection 2022 Jul.
Inflammatory bowel disease (IBD) includes ulcerative colitis (UC) and Crohn's disease (CD) characterized by a fluctuating course with periods of clinical activity and remission. No previous studies have demonstrated the frequency of delay at diagnosis and its associated factors in Mexico and Latin America. The aim of this study was to evaluate diagnostic delay of IBD in the last 4 decades in 2 different health care systems (public vs. private) and its associated factors.
This is a cohort study that included 1,056 patients with a confirmed diagnosis of IBD from public and private health care systems. The diagnostic delay was defined as time >1 year from the onset of symptoms to the confirmed diagnosis for patients with UC and 2 years for patients with CD. Statistical analysis was performed with the SPSS v.24 program. A value of ≤ 0.05 was taken as significant.
The delay at diagnosis decreased significantly by 24.9% in the last 4 decades. The factors associated with the diagnostic delay were proctitis in UC, clinical course >2 relapses per year and IBD surgeries for CD. We found a delay at diagnosis in 35.2% of IBD patients in the public versus 16.9% in the private health care system ( = 0.00001).
We found a significant diagnosis delay of IBD in 35.2% from the public health care system versus 16.9% in the private health care system.
炎症性肠病（IBD）包括溃疡性结肠炎（UC）和克罗恩病（CD），其特征为病情波动，有临床活动期和缓解期。此前尚无研究表明墨西哥和拉丁美洲IBD诊断延迟的发生率及其相关因素。本研究旨在评估过去40年中，在两种不同医疗体系（公立与私立）中IBD的诊断延迟情况及其相关因素。
这是一项队列研究，纳入了1056例来自公立和私立医疗体系且确诊为IBD的患者。诊断延迟定义为UC患者从症状出现到确诊时间>1年，CD患者为2年。使用SPSS v.24程序进行统计分析。P≤0.05为有统计学意义。
在过去40年中，诊断延迟显著降低了24.9%。与诊断延迟相关的因素包括UC中的直肠炎、每年临床复发>2次以及CD的IBD手术。我们发现公立医疗体系中35.2%的IBD患者存在诊断延迟，而私立医疗体系中这一比例为16.9%（P=0.00001）。
我们发现公立医疗体系中35.2%的IBD患者存在显著的诊断延迟，而私立医疗体系中这一比例为16.9%。
