Diagnostic Delay in Romanian @entity1 with XXXX : Risk Factors and Impact on the Disease Course and Need for Surgery.

@entity1 @entity31 @entity29 @entity1960 @entity292 @entity30
BACKGROUND: The epidemiology of @entity29 [ @entity29 ] in Eastern Europe is poorly understood, particularly with regard to diagnostic delay. Here we investigated the factors leading to delayed diagnosis and the effect of the delay on several disease progression and outcome measures. METHODS: A total of 1196 @entity29 cases [682 @entity31 [ @entity31 ], 478 @entity30 [ @entity30 ], 36 indeterminate @entity1960 ] from the Romanian national registry IBDPROSPECT were reviewed. Standard clinical and demographic factors were evaluated as predictors of a long diagnostic delay in both @entity30 and @entity31 . Diagnostic delay was subsequently evaluated as a potential risk factor for bowel stenoses, bowel @entity292 , perianal @entity292 , perianal surgery, and intestinal surgery in @entity30 @entity1 . RESULTS: The median diagnostic delay was significantly longer in @entity30 [5 months] than in @entity31 [1 month] @entity1 [p < 0.001]. Compared with 5 months for @entity31 @entity1 , 75% of @entity30 @entity1 were diagnosed within 18 months of symptom onset. In @entity30 @entity1 , extra-ileal location was a protective factor (odds ratio [OR], 0.5; p = 0.03), whereas being an active smoker [OR, 2.09; p = 0.01] and symptom onset during summer [OR, 3.35; p < 0.001] were independent risk factors for a long diagnostic delay [> 18 months]. In @entity31 @entity1 , an age > 40 years was a protective factor [OR, 0.68; p = 0.04] for a long delay. Regarding outcomes, a long diagnostic delay in @entity30 @entity1 positively correlated with bowel stenoses [OR, 3.38; p < 0.01] and any @entity29 -related surgery [OR, 1.95; p = 0.03] and had a positive trend for intestinal @entity292 [OR, 2.64; p = 0.08] and perianal @entity292 [OR, 2.9; p = 0.07]. Disease duration since diagnosis positively correlated with bowel stenoses [OR, 1.04; p = 0.04], any @entity29 -related surgery [OR, 1.04; p = 0.02], and intestinal surgery [OR, 1.07; p < 0.01]. CONCLUSIONS: A long diagnostic delay in @entity29 correlates with an increased frequency of bowel stenoses and need for @entity29 -related surgery.
