Impact of Diagnostic Delay on Disease Course in Pediatric Versus Adult-onset Patients with Ulcerative Colitis: Data from the Swiss IBD Cohort

Introduction: Given the lack of data we aimed to assess the impact of the length of diagnostic delay on natural history of ulcerative colitis in pediatric (diagnosed <18 years) and adult patients (diagnosed ≥18 years). Methods: Data from the Swiss Inflammatory Bowel Disease cohort study were ana...

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Autores principales:	Alain M. Schoepfer, Vu Dang Chau Tran, Jean-Benoit Rossel, Christiane Sokollik, Johannes Spalinger, Ekaterina Safroneeva, Thea von Graffenried, Sebastien Godat, Dieter Hahnloser, Stephan R. Vavricka, Christian Braegger, Andreas Nydegger
Formato:	article
Lenguaje:	EN
Publicado:	Karger Publishers 2021
Materias:	Diseases of the digestive system. Gastroenterology RC799-869
Acceso en línea:	https://doaj.org/article/8151c6b706df44348f52dec6049146e4
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spelling	oai:doaj.org-article:8151c6b706df44348f52dec6049146e42021-12-02T12:40:23ZImpact of Diagnostic Delay on Disease Course in Pediatric Versus Adult-onset Patients with Ulcerative Colitis: Data from the Swiss IBD Cohort2296-94032296-936510.1159/000520995https://doaj.org/article/8151c6b706df44348f52dec6049146e42021-11-01T00:00:00Zhttps://www.karger.com/Article/FullText/520995https://doaj.org/toc/2296-9403https://doaj.org/toc/2296-9365Introduction: Given the lack of data we aimed to assess the impact of the length of diagnostic delay on natural history of ulcerative colitis in pediatric (diagnosed <18 years) and adult patients (diagnosed ≥18 years). Methods: Data from the Swiss Inflammatory Bowel Disease cohort study were analyzed. Diagnostic delay was defined as interval between the first appearance of UC-related symptoms until diagnosis. Logistic regression modeling evaluated the appearance of the following complications in the long term according to the length of diagnostic delay: colonic dysplasia, colorectal cancer, UC-related hospitalization, colectomy, and extra-intestinal manifestations (EIM). Results: A total of 184 pediatric and 846 adult patients were included. Median diagnostic delay was 4 [IQR 2-7.5] months for the pediatric-onset group and 3 [IQR 2-10] months for the adult-onset group (P=0.873). In both, pediatric and adult-onset groups, length of diagnostic delay at UC diagnosis was not associated with colectomy, UC-related hospitalization, colon dysplasia, and colorectal cancer. EIM were significantly more prevalent at UC diagnosis in the adult-onset group with long diagnostic delay compared to the adult-onset group with short diagnostic delay (p = 0.022). In the long term, length of diagnostic delay was associated in the adult onset group with colorectal dysplasia (p=0.023), EIMs (p<0.001) and more specifically arthritis/arthralgias (p<0.001) and ankylosing spondylitis/sacroiliitis (p<0.001). In the pediatric-onset UC group, length of diagnostic delay in the long term was associated with arthritis/arthralgias (p=0.017); however, it was not predictive for colectomy and UC-related hospitalization. Conclusions: As colorectal cancer and EIMs are associated with considerable morbidity and costs, every effort should be made to reduce diagnostic delay in UC patients.Alain M. SchoepferVu Dang Chau TranJean-Benoit RosselChristiane SokollikJohannes SpalingerEkaterina SafroneevaThea von GraffenriedSebastien GodatDieter HahnloserStephan R. VavrickaChristian BraeggerAndreas NydeggerKarger PublishersarticleDiseases of the digestive system. GastroenterologyRC799-869ENInflammatory Intestinal Diseases (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the digestive system. Gastroenterology RC799-869
spellingShingle	Diseases of the digestive system. Gastroenterology RC799-869 Alain M. Schoepfer Vu Dang Chau Tran Jean-Benoit Rossel Christiane Sokollik Johannes Spalinger Ekaterina Safroneeva Thea von Graffenried Sebastien Godat Dieter Hahnloser Stephan R. Vavricka Christian Braegger Andreas Nydegger Impact of Diagnostic Delay on Disease Course in Pediatric Versus Adult-onset Patients with Ulcerative Colitis: Data from the Swiss IBD Cohort
description	Introduction: Given the lack of data we aimed to assess the impact of the length of diagnostic delay on natural history of ulcerative colitis in pediatric (diagnosed <18 years) and adult patients (diagnosed ≥18 years). Methods: Data from the Swiss Inflammatory Bowel Disease cohort study were analyzed. Diagnostic delay was defined as interval between the first appearance of UC-related symptoms until diagnosis. Logistic regression modeling evaluated the appearance of the following complications in the long term according to the length of diagnostic delay: colonic dysplasia, colorectal cancer, UC-related hospitalization, colectomy, and extra-intestinal manifestations (EIM). Results: A total of 184 pediatric and 846 adult patients were included. Median diagnostic delay was 4 [IQR 2-7.5] months for the pediatric-onset group and 3 [IQR 2-10] months for the adult-onset group (P=0.873). In both, pediatric and adult-onset groups, length of diagnostic delay at UC diagnosis was not associated with colectomy, UC-related hospitalization, colon dysplasia, and colorectal cancer. EIM were significantly more prevalent at UC diagnosis in the adult-onset group with long diagnostic delay compared to the adult-onset group with short diagnostic delay (p = 0.022). In the long term, length of diagnostic delay was associated in the adult onset group with colorectal dysplasia (p=0.023), EIMs (p<0.001) and more specifically arthritis/arthralgias (p<0.001) and ankylosing spondylitis/sacroiliitis (p<0.001). In the pediatric-onset UC group, length of diagnostic delay in the long term was associated with arthritis/arthralgias (p=0.017); however, it was not predictive for colectomy and UC-related hospitalization. Conclusions: As colorectal cancer and EIMs are associated with considerable morbidity and costs, every effort should be made to reduce diagnostic delay in UC patients.
format	article
author	Alain M. Schoepfer Vu Dang Chau Tran Jean-Benoit Rossel Christiane Sokollik Johannes Spalinger Ekaterina Safroneeva Thea von Graffenried Sebastien Godat Dieter Hahnloser Stephan R. Vavricka Christian Braegger Andreas Nydegger
author_facet	Alain M. Schoepfer Vu Dang Chau Tran Jean-Benoit Rossel Christiane Sokollik Johannes Spalinger Ekaterina Safroneeva Thea von Graffenried Sebastien Godat Dieter Hahnloser Stephan R. Vavricka Christian Braegger Andreas Nydegger
author_sort	Alain M. Schoepfer
title	Impact of Diagnostic Delay on Disease Course in Pediatric Versus Adult-onset Patients with Ulcerative Colitis: Data from the Swiss IBD Cohort
title_short	Impact of Diagnostic Delay on Disease Course in Pediatric Versus Adult-onset Patients with Ulcerative Colitis: Data from the Swiss IBD Cohort
title_full	Impact of Diagnostic Delay on Disease Course in Pediatric Versus Adult-onset Patients with Ulcerative Colitis: Data from the Swiss IBD Cohort
title_fullStr	Impact of Diagnostic Delay on Disease Course in Pediatric Versus Adult-onset Patients with Ulcerative Colitis: Data from the Swiss IBD Cohort
title_full_unstemmed	Impact of Diagnostic Delay on Disease Course in Pediatric Versus Adult-onset Patients with Ulcerative Colitis: Data from the Swiss IBD Cohort
title_sort	impact of diagnostic delay on disease course in pediatric versus adult-onset patients with ulcerative colitis: data from the swiss ibd cohort
publisher	Karger Publishers
publishDate	2021
url	https://doaj.org/article/8151c6b706df44348f52dec6049146e4
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Impact of Diagnostic Delay on Disease Course in Pediatric Versus Adult-onset Patients with Ulcerative Colitis: Data from the Swiss IBD Cohort

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