Factors associated with long diagnostic delay in celiac disease

被引:79
作者
Fuchs, Valma [1 ,2 ]
Kurppa, Kalle [1 ,2 ]
Huhtala, Heini [3 ]
Collin, Pekka [4 ]
Maki, Markku [1 ,2 ]
Kaukinen, Katri [5 ,6 ]
机构
[1] Univ Tampere, Tampere Ctr Child Hlth Res, FIN-33014 Tampere, Finland
[2] Tampere Univ Hosp, Tampere, Finland
[3] Univ Tampere, Tampere Sch Hlth Sci, FIN-33014 Tampere, Finland
[4] Univ Tampere, Tampere Univ Hosp, Sch Med, Dept Gastroenterol & Alimentary Tract Surg, FIN-33014 Tampere, Finland
[5] Tampere Univ Hosp, Sch Med, Dept Internal Med, Tampere, Finland
[6] Seinajoki Cent Hosp, Seinajoki, Finland
基金
芬兰科学院;
关键词
adults; celiac disease; current care guidelines; diagnostic delay; QUALITY-OF-LIFE; IRRITABLE-BOWEL-SYNDROME; HEALTH-CARE SERVICES; GLUTEN-FREE DIET; INCREASING PREVALENCE; SYMPTOMS; MALIGNANCY; NATIONWIDE; CHILDREN; FINLAND;
D O I
10.3109/00365521.2014.923502
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Objective. Here, we investigated the factors associated with long diagnostic delay in celiac disease and the impact of the national Current Care Guidelines in reducing the delay. Material and methods. This population-based study involved 825 adult celiac disease patients. The diagnosis was considered delayed when the interval between first symptoms and diagnosis was > 10 years. The patients were asked about the duration and type of symptoms before diagnosis, time and site (tertiary, secondary, or primary care) of the diagnosis, family history of the disease, and presence of significant comorbidities. Analysis was performed by binary logistic regression. Results. Altogether, 261 (32%) out of 825 participants reported a diagnostic delay of > 10 years. Female gender, neurological or musculoskeletal disorders and presence of diarrhea, abdominal pain, and malabsorption were associated with prolonged delay. Male gender, diagnosis after the introduction of the first Current Care Guidelines in 1997, and being detected by serological screening, and family history of celiac disease were associated with a lower risk of delayed diagnosis. Factors not associated with the delay were site of diagnosis, age, and presence of dermatitis herpetiformis, type 1 diabetes, or thyroidal disease. Conclusion. The number of long diagnostic delays in celiac disease has decreased over the past decades. The shift of diagnostics from secondary and tertiary care to primary care has not been detrimental. National guidelines together with increased awareness and active screening in at-risk groups of celiac disease are important in these circumstances.
引用
收藏
页码:1304 / 1310
页数:7
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