Rheumatology Unit, Università Politecnica delle Marche, Carlo Urbani Hospital, Jesi, Ancona, Italy.
Clin Exp Rheumatol. 2024 Jun;42(6):1198-1204. doi: 10.55563/clinexprheumatol/ta9xtc. Epub 2024 Jul 4.
To evaluate the impact of the diagnostic delay on fibromyalgia (FM) severity.
Data were retrospectively extracted from a large database of patients with FM belonging to the Italian Fibromyalgia Registry (IFR) residents on the Marche Region. The diagnosis of FM was formulated according to the 2016 American College of Rheumatology (ACR) criteria. The following information was obtained: time to diagnosis [categorised in early diagnosis (ED) if FM diagnosed within one year, late diagnosis (LD) if FM diagnosed more than 1 year but less than 5 years, and very late diagnosis (VLD) if FM diagnosed over 5 years from symptoms onset], revised Fibromyalgia Impact Questionnaire (FIQR), modified Fibromyalgia Assessment Status (FASmod), and Polysymptomatic Distress Scale (PDS) [consisting of the sum of Widespread Pain Index (WPI) and Symptom Severity Scale (SSS)].
The study included 616 FM patients (92.2% female), with a mean disease duration of 6.46 (SD 4.14) years and a mean (SD) time to diagnosis of 3.45 (2.39) years. The ED group included 169 patients, the LD 320 patients, and the VLD 127 patients. Comparing the differences among groups, a significant difference in disease severity was observed in all the clinimetric indices in increasing the time to reach the diagnosis (p=0.000001): the median PDS scores were 13.36 (interquartile range [IQR] 7.00-20.00), 16.09 (IQR 9.00-22.00), and 23.00 (IQR 18.25-26.00) for ED, LD, and VLD, respectively.
Delayed diagnosis is associated with poorer patient outcomes, including worsening severity.
评估诊断延迟对纤维肌痛（FM）严重程度的影响。
数据从意大利纤维肌痛登记处（IFR）的马切拉塔地区的患者大型数据库中回顾性提取。FM 的诊断根据 2016 年美国风湿病学会（ACR）标准制定。获得以下信息：诊断时间[分为早期诊断（ED），如果 FM 在 1 年内诊断；晚期诊断（LD），如果 FM 在 1 至 5 年内诊断；非常晚期诊断（VLD），如果 FM 在症状发作 5 年以上诊断]；修订后的纤维肌痛影响问卷（FIQR）、改良纤维肌痛评估状态（FASmod）和多症状困扰量表（PDS）[由广泛性疼痛指数（WPI）和症状严重程度量表（SSS）之和组成]。
该研究纳入了 616 名 FM 患者（92.2%为女性），平均病程为 6.46（SD 4.14）年，平均（SD）诊断时间为 3.45（2.39）年。ED 组包括 169 名患者，LD 组包括 320 名患者，VLD 组包括 127 名患者。比较各组之间的差异，在所有临床测量指标中，随着达到诊断的时间延长，疾病严重程度均存在显著差异（p=0.000001）：ED、LD 和 VLD 组的 PDS 中位数评分分别为 13.36（四分位距 [IQR] 7.00-20.00）、16.09（IQR 9.00-22.00）和 23.00（IQR 18.25-26.00）。
诊断延迟与较差的患者预后相关，包括病情恶化。
