Diagnostic delay in psoriatic arthritis: insights from a nationwide multicenter study.

Autor: Kılıç G; Division of Rheumatology, Department of PMR, Karadeniz Technical University School of Medicine, Trabzon, Turkey. gkilic.md@hotmail.com., Kılıç E; Rheumatology Clinic, Kanuni Training and Research Hospital, Trabzon, Turkey., Tekeoğlu İ; Division of Rheumatology and Immunology, Department of PMR, Sakarya University School of Medicine, Sakarya, Turkey., Sargın B; Division of Rheumatology, Department of PMR, Adnan Menderes University School of Medicine, Aydın, Turkey., Cengiz G; Division of Rheumatology, Department of PMR, Erciyes University School of Medicine, Kayseri, Turkey., Balta NC; Division of Rheumatology, Department of PMR, Hatay Mustafa Kemal University School of Medicine, Hatay, Turkey., Alkan H; Department of PMR, Pamukkale University School of Medicine, Denizli, Turkey., Kasman SA; Division of Rheumatology, Department of PMR, Marmara University School of Medicine, Istanbul, Turkey., Şahin N; Department of PMR, Balıkesir University School of Medicine, Balıkesir, Turkey., Orhan K; Rheumatology Clinic, Ankara Bilkent City Hospital, Ankara, Turkey., Gezer İA; Department of PMR, Selçuk University School of Medicine, Konya, Turkey., Keskin D; Department of PMR, Kırıkkale University School of Medicine, Kırıkkale, Turkey., Mülkoğlu C; Department of PMR, Health Sciences of University, Ankara Training and Research Hospital, Ankara, Turkey., Reşorlu H; Department of PMR, Çanakkale Onsekiz Mart University School of Medicine, Çanakkale, Turkey., Ataman Ş; Division of Rheumatology, Department of PMR, Ankara University School of Medicine, Ankara, Turkey., Bal A; Department of PMR, University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey., Duruöz MT; Division of Rheumatology, Department of PMR, Marmara University School of Medicine, Istanbul, Turkey., Kücükakkaş O; NMC Speciality Hospital-Dubai Investment Park, Dubai, United Arab Emirates., Şen N; Department of Rheumatology, Kartal Dr. Lütfi Kırdar Training and Research Hospital, Istanbul, Turkey., Toprak M; Department of PMR, Yüzüncü Yıl University School of Medicine, Van, Turkey., Yurdakul OV; Department of PMR, Bezmiâlem Foundation University, Istanbul, Turkey., Melikoğlu MA; Division of Rheumatology, Department of PMR, Atatürk University School of Medicine, Erzurum, Turkey., Ayhan FF; Department of PMR, Atılım University School of Medicine, Ankara, Turkey., Baykul M; Hatay Dörtyol State Hospital, Hatay, Turkey., Bodur H; Department of PMR, Yıldırım Beyazıt University School of Medicine, Ankara, Turkey., Çalış M; Division of Rheumatology, Department of PMR, Erciyes University School of Medicine, Kayseri, Turkey., Çapkın E; Division of Rheumatology, Department of PMR, Karadeniz Technical University School of Medicine, Trabzon, Turkey., Devrimsel G; Department of PMR, Recep Tayyip Erdoğan University School of Medicine, Rize, Turkey., Hizmetli S; Division of Rheumatology, Department of PMR, Cumhuriyet University School of Medicine, Sivas, Turkey., Kamanlı A; Division of Rheumatology and Immunology, Department of PMR, Sakarya University School of Medicine, Sakarya, Turkey., Keskin Y; Department of PMR, Bezmiâlem Foundation University, Istanbul, Turkey., Ecesoy H; Division of Rheumatology, Department of PMR, Karamanoğlu Mehmetbey University, Karaman, Turkey., Kutluk Ö; Division of Rheumatology, Department of PMR, Akdeniz University School of Medicine, Antalya, Turkey., Şendur ÖF; Department of PMR, Medicana International İzmir Hospital, İzmir, Turkey., Tolu S; Department of PMR, Medipol University School of Medicine, Istanbul, Turkey., Tuncer T; Division of Rheumatology, Department of PMR, Akdeniz University School of Medicine, Antalya, Turkey., Nas K; Division of Rheumatology and Immunology, Department of PMR, Sakarya University School of Medicine, Sakarya, Turkey.
Jazyk: angličtina
Zdroj: Rheumatology international [Rheumatol Int] 2024 Jun; Vol. 44 (6), pp. 1051-1059. Date of Electronic Publication: 2023 Oct 08.
DOI: 10.1007/s00296-023-05479-z
Abstrakt: This study aimed to investigate the duration of diagnostic delay in patients with psoriatic arthritis (PsA) and identify potential contributing factors using a comprehensive, population-based approach. Data were obtained from the Turkish League Against Rheumatism (TLAR)-Network, involving patients who met the CASPAR criteria. Diagnostic delay was defined as time interval from symptom onset to PsA diagnosis, categorized as ≤ 2 years and > 2 years. Temporal trends were assessed by grouping patients based on the year of diagnosis. Various factors including demographics, clinical characteristics, disease activity, quality of life, physical function, disability, fatigue, and well-being were examined. Logistic regression models were used to identify factors associated with diagnostic delay. Among 1,134 PsA patients, mean diagnostic delay was 35.1 months (median: 12). Approximately 39.15% were diagnosed within 3 months, and 67.02% were diagnosed within 24 months. Patients experiencing longer delays had higher scores in Psoriatic Arthritis Quality of Life Questionnaire (PsAQoL), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), patient's global assessment (PtGA) and physician's global assessment (PhGA). Diagnostic delay has decreased over time, with median delay falling from 60 to 24 months throughout pre-2010 and 2015-2019 terms. Several factors were identified as significant contributors to delayed diagnosis, including lower levels of education (OR = 2.63), arthritis symptoms preceding skin manifestations (OR = 1.72), low back pain at first visit (OR = 1.60), symptom onset age (OR = 0.96), and psoriasis subtype (OR = 0.25). Timely diagnosis of PsA is crucial for effective management and improved outcomes. Despite recent improvements, about one-third of PsA patients still experience delays exceeding 2 years. By identifying influential factors such as education level, arthritis symptoms preceding skin manifestations, initial visit symptoms, age of symptom onset, and psoriasis subtype, healthcare practitioners may create specific techniques to help in early detection and intervention.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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