Al Thoubaity Fatma Khinaifis, Albukhari Rana Mazin, AlQurashi Shahad Ghazi, Alghamdi Yasmeen Saeed, Mohammed Modhi Sultan, Ashgan Nouf Turki, Nabalawi Lujain Yousef, Batarji Jana Fahad, Qashaa Nuha Ibrahim, Alsaedi Rahaf Ahmed, Basheikh Noor Ibraheem
Department of General Surgery, King Abdulaziz University Faculty of Medicine, Jeddah, Saudi Arabia.
Medical student, King Abdulaziz University Faculty of Medicine, Jeddah, Saudi Arabia.
Ann Med Surg (Lond). 2025 Jul 16;87(8):4735-4741. doi: 10.1097/MS9.0000000000003489. eCollection 2025 Aug.
Despite a steady increase in cases, concerns persist about how early diagnosis affects Crohn's disease (CD) progression.
To assess the association between early (CD) diagnosis and clinical complications among adults.
A retrospective study was conducted on 149 patients aged 18 years or older who were admitted anddiagnosed with CD between 2000 and 2022. Data on demographics, admission portal, family history, risk factors, past medical history, clinical presentations, complications, recurrence, disease-modifying agents, and laboratory investigations were collected. Diagnostic delay was defined as the time from diagnosis to the 75th percentile.
The mean age was 35.85 ± 12.54 years, with a mean disease duration of 7.72 ± 4.02 years; the average time from symptom onset to diagnosis was 1.93 ± 3.2 years, and from the diagnosis to complications was 2.2 ± 3.0 years. Males comprised 57% of patients, and 80.5% were S nationals. Colonoscopy with biopsy diagnosed 64.4%, and 8.7% had a family history of CD. Of these, 118 (79.2%) had an early diagnosis, while 31 (20.8%) had a late diagnosis. Late-diagnosed patients had a significantly longer time to diagnose complications and were more likely to be non-S. They also had a higher prevalence of kidney oxalate calculi and Asacol use, while early-diagnosed patients had a reduced appetite and fatigue. Multivariate logistic regression found no significant risk factors for late diagnosis.
Delayed CD diagnosis is associated with kidney oxalate calculi. The link between early diagnosis and clinical complications remains inconclusive, requiring further multicenter longitudinal studies.
尽管病例数稳步增加,但对于早期诊断如何影响克罗恩病(CD)进展仍存在担忧。
评估成人早期CD诊断与临床并发症之间的关联。
对2000年至2022年间收治并诊断为CD的149例18岁及以上患者进行回顾性研究。收集了人口统计学、入院途径、家族史、危险因素、既往病史、临床表现、并发症、复发、疾病缓解药物和实验室检查等数据。诊断延迟定义为从诊断到第75百分位数的时间。
平均年龄为35.85±12.54岁,平均病程为7.72±4.02年;从症状出现到诊断的平均时间为1.93±3.2年,从诊断到出现并发症的平均时间为2.2±3.0年。男性占患者的57%,80.5%为S国人。结肠镜检查及活检确诊率为64.4%,8.7%有CD家族史。其中,118例(79.2%)为早期诊断,31例(20.8%)为晚期诊断。晚期诊断患者诊断出并发症的时间明显更长,且更可能不是S国人。他们还更易患草酸钙肾结石且使用艾莎可(Asacol),而早期诊断患者食欲减退和疲劳症状更多见。多因素逻辑回归分析未发现晚期诊断的显著危险因素。
CD诊断延迟与草酸钙肾结石有关。早期诊断与临床并发症之间的联系仍不明确,需要进一步开展多中心纵向研究。