Diagnostic delay in adult coeliac disease: An Italian multicentre study

Autor: Marco Vincenzo Lenti, Nicola Aronico, Paola Ilaria Bianchi, Carmela Cinzia D'Agate, Matteo Neri, Umberto Volta, Maria Gloria Mumolo, Marco Astegiano, Antonino Salvatore Calabrò, Fabiana Zingone, Giovanni Latella, Antonio Di Sario, Antonio Carroccio, Carolina Ciacci, Francesco Luzza, Carmela Bagnato, Massimo Claudio Fantini, Luca Elli, Giovanni Cammarota, Antonio Gasbarrini, Piero Portincasa, Mario Andrea Latorre, Clarissa Petrucci, Claudia Quatraccioni, Chiara Iannelli, Nicoletta Vecchione, Carlo Maria Rossi, Giacomo Broglio, Gianluca Ianiro, Ilaria Marsilio, Stefano Bibbò, Beatrice Marinoni, Donatella Tomaselli, Ludovico Abenavoli, Riccardo Pilia, Giovanni Santacroce, Erica Lynch, Antonella Carrieri, Pasquale Mansueto, Margherita Gabba, Giacomo Alunno, Chiara Rossi, Francesca Onnis, Konstantinos Efthymakis, Nicola Cesaro, Marta Vernero, Federica Baiano Svizzero, Francesco Paolo Semeraro, Marco Silano, Alessandro Vanoli, Catherine Klersy, Gino Roberto Corazza, Antonio Di Sabatino
Rok vydání: 2022
Předmět:
Zdroj: Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver.
ISSN: 1878-3562
Popis: There are few data regarding the diagnostic delay and its predisposing factors in coeliac disease (CD).To investigate the overall, the patient-dependant, and the physician-dependant diagnostic delays in CD.CD adult patients were retrospectively enroled at 19 Italian CD outpatient clinics (2011-2021). Overall, patient-dependant, and physician-dependant diagnostic delays were assessed. Extreme diagnostic, i.e., lying above the third quartile of our population, was also analysed. Multivariable regression models for factors affecting the delay were fitted.Overall, 2362 CD patients (median age at diagnosis 38 years, IQR 27-46; M:F ratio=1:3) were included. The median overall diagnostic delay was 8 months (IQR 5-14), while patient- and physician-dependant delays were 3 (IQR 2-6) and 4 (IQR 2-6) months, respectively. Previous misdiagnosis was associated with greater physician-dependant (1.076, p = 0.005) and overall (0.659, p = 0.001) diagnostic delays. Neurological symptoms (odds ratio 2.311, p = 0.005) and a previous misdiagnosis (coefficient 9.807, p = 0.000) were associated with a greater extreme physician-dependant delay. Gastrointestinal symptoms (OR 1.880, p = 0.004), neurological symptoms (OR 2.313, p = 0.042), and previous misdiagnosis (OR 4.265, p = 0.000) were associated with increased extreme overall diagnostic delay.We identified some factors that hamper CD diagnosis. A proper screening strategy for CD should be implemented.
Databáze: OpenAIRE