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Diagnostic delay in patients with inflammatory bowel disease in Austria

  • Gottfried NovacekEmail author
  • Hans Peter Gröchenig
  • Thomas Haas
  • Heimo Wenzl
  • Pius Steiner
  • Robert Koch
  • Thomas Feichtenschlager
  • Gerald Eckhardt
  • Andreas Mayer
  • Andreas Kirchgatterer
  • Othmar Ludwiczek
  • Reingard Platzer
  • Pavol Papay
  • Johanna Gartner
  • Harry Fuchssteiner
  • Wolfgang Miehsler
  • Paul-Gerhard Peters
  • Gerhard Reicht
  • Harald Vogelsang
  • Clemens Dejaco
  • Thomas Waldhör
  • Austrian IBD Study Group (ATISG)
original article
  • 12 Downloads

Summary

Background

Delayed diagnosis seems to be common in inflammatory bowel diseases (IBD). The study was carried out to investigate the diagnostic delay and associated risk factors in Austrian IBD patients.

Methods

In a multicenter cross-sectional study adult patients with IBD attending 18 Austrian outpatient clinics completed a multi-item questionnaire that recorded medical and socioeconomic characteristics. The study outcome was diagnostic delay defined as the period from symptom onset to diagnosis of IBD.

Results

A total of 1286 patients (Crohn’s disease 830, ulcerative colitis 435, inflammatory bowel disease unclassified 21; females 651) with a median age of 40 years (interquartile range 31–52 years) and a median disease duration of 10 years (4–18 years) were analyzed. The median diagnostic delay was 6 months (2–23 months) in Crohn’s disease and 3 months (1–10 months) in ulcerative colitis (p < 0.001). In the multivariable regression analysis Crohn’s disease, greater age at diagnosis and a high educational level (compared to middle degree level) were independently associated with longer diagnostic delay.

Conclusion

The diagnostic delay was longer in Crohn’s disease than in ulcerative colitis patients and was associated with greater age at diagnosis and a higher educational level.

Keywords

Crohn’s disease Ulcerative colitis Age at diagnosis Educational level Surgery 

Abbreviations

CD

Crohn’s disease

CI

Confidence interval

DD

Diagnostic delay

IBD

Inflammatory bowel disease

IBDIS

Inflammatory bowel disease information system

IBDU

Inflammatory bowel disease unclassified

IQR

Interquartile range

UC

Ulcerative colitis

Notes

Acknowledgements

The authors wish to thank the European Federation of Crohn’s and Ulcerative Colitis Association (EFCCA) and Prof. Di Sabatino for placing additional data from their publications at their disposal, which are given in Tables 4 and 5. The manuscript was linguistically reviewed by David Westacott.

Compliance with ethical guidelines

Conflict of interest

G. Novacek, H.P. Gröchenig, T. Haas, H. Wenzl, P. Steiner, R. Koch, T. Feichtenschlager, G. Eckhardt, A. Mayer, A. Kirchgatterer, O. Ludwiczek, R. Platzer, P. Papay, J. Gartner, H. Fuchssteiner, W. Miehsler, P.-G. Peters, G. Reicht, H. Vogelsang, C. Dejaco, and T. Waldhör declare that they have no competing interests.

Ethical standards

Ethics approval and consent to participate: The study was approved by all responsible local ethics committees (Ethics Committee of the Medical University of Vienna: EC No. 1450/2014; 1‑JUL-2014) and was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. The patients were informed about the study both verbally and in writing. A written informed consent was not applicable since the questionnaire was anonymous.

Supplementary material

508_2019_1451_MOESM1_ESM.docx (18 kb)
The Supplementary Material includes the comparison of diagnostic delay recorded in a database (Inflammatory Bowel Disease Information System; IBDIS) versus actually stated by the patients in 110 consective IBD patients at the Department of Gastroenterology and Hepatology of the Medical University of Vienna.

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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2019

Authors and Affiliations

  • Gottfried Novacek
    • 1
    Email author
  • Hans Peter Gröchenig
    • 2
  • Thomas Haas
    • 3
  • Heimo Wenzl
    • 4
  • Pius Steiner
    • 5
  • Robert Koch
    • 6
  • Thomas Feichtenschlager
    • 7
  • Gerald Eckhardt
    • 8
  • Andreas Mayer
    • 9
  • Andreas Kirchgatterer
    • 10
  • Othmar Ludwiczek
    • 11
  • Reingard Platzer
    • 12
  • Pavol Papay
    • 13
  • Johanna Gartner
    • 14
  • Harry Fuchssteiner
    • 15
  • Wolfgang Miehsler
    • 16
  • Paul-Gerhard Peters
    • 17
  • Gerhard Reicht
    • 18
  • Harald Vogelsang
    • 1
  • Clemens Dejaco
    • 1
  • Thomas Waldhör
    • 19
  • Austrian IBD Study Group (ATISG)
  1. 1.Department of Internal Medicine III, Division of Gastroenterology and HepatologyMedical University of ViennaViennaAustria
  2. 2.Department of Internal MedicineBrothers of St. John of God Hospital, St. Veit an der GlanSt. Veit an der GlanAustria
  3. 3.Darmpraxis SalzburgSalzburgAustria
  4. 4.Department of Internal Medicine, Division of Gastroenterology and HepatologyMedical University of GrazGrazAustria
  5. 5.Department of Internal Medicine IWels-Grieskirchen HospitalWelsAustria
  6. 6.Department of Internal Medicine IMedical University of InnsbruckInnsbruckAustria
  7. 7.Department of Internal Medicine IVRudolfstiftung HospitalViennaAustria
  8. 8.Department of Internal MedicineOberpullendorf HospitalOberpullendorfAustria
  9. 9.Department of Internal Medicine IIUniversitätsklinikum St. PöltenSt. PöltenAustria
  10. 10.Department of Internal Medicine VWels-Grieskirchen HospitalGrieskirchenAustria
  11. 11.Department of Internal MedicineHall in Tirol HospitalHall in TirolAustria
  12. 12.Department of Internal Medicine IWiener Neustadt HospitalWiener NeustadtAustria
  13. 13.Department of Internal MedicineFranziskus HospitalViennaAustria
  14. 14.Department of Internal MedicineHanusch HospitalViennaAustria
  15. 15.Department of Internal Medicine IVElisabethinen HospitalLinzAustria
  16. 16.Department of Internal MedicineBrothers of St. John of God HospitalSalzburgAustria
  17. 17.Department of Internal MedicineFeldkirch HospitalFeldkirchAustria
  18. 18.Department of Internal Medicine IIBrothers of St. John of God HospitalGrazAustria
  19. 19.Department of Epidemiology, Center for Public HealthMedical University of ViennaViennaAustria

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