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Clinical factors and disease course related to diagnostic delay in Korean Crohn's disease patients: Results from the CONNECT study

Title
Clinical factors and disease course related to diagnostic delay in Korean Crohn's disease patients: Results from the CONNECT study
Authors
Moon C.M.Jung S.-A.Kim S.-E.Song H.J.Jung Y.Ye B.D.Cheon J.H.Kim Y.S.Kim Y.-H.Kim J.S.Han D.S.
Ewha Authors
정성애김성은문창모
SCOPUS Author ID
정성애scopus; 김성은scopus; 문창모scopus
Issue Date
2015
Journal Title
PLoS ONE
ISSN
1932-6203JCR Link
Citation
vol. 10, no. 12
Publisher
Public Library of Science
Indexed
SCIE; SCOPUS WOS scopus
Abstract
Diagnostic delay frequently occurs in Crohn's disease (CD) patients because of diagnostic limitations. However, diagnostic delay and its related factors remain poorly defined. Therefore, we aimed to identify the predictors associated with diagnostic delay and to evaluate the impact of diagnostic delay on clinical course in a Korean CD patient cohort. We performed a multicenter retrospective analysis of 1,047 CD patients registered in the Crohn's Disease Clinical Network and Cohort study in Korea. The mean interval of diagnostic delay was 16.0 ± 33.1 months. Multivariate analysis showed that older age at diagnosis (≥40 years) (p = 0.014), concomitant upper gastrointestinal (UGI) disease (p = 0.012) and penetrating disease behavior at diagnosis (p = 0.001) were positively associated with long diagnostic delay (≥18 months). During the longitudinal follow-up, long diagnostic delay was independently predictive of further development of intestinal stenosis (hazard ratio [HR], 1.43; 95% confidence interval [CI], 1.07-1.93; p = 0.017), internal fistulas (HR, 1.62; 95% CI, 1.12-2.33; p = 0.011), and perianal fistulas (HR, 1.38; 95% CI, 1.06-1.80; p = 0.016). However, as for the risk of abscess formation, bowel perforation, and CD-related abdominal surgery, no significant association with diagnostic delay was observed. Older age at diagnosis, UGI involvement, and penetrating behavior are associated with long diagnostic delay in Korean CD patients. Moreover, diagnostic delay is associated with an increased risk of CDrelated complications such as intestinal stenosis, internal fistulas, and perianal fistulas. © 2015 Moon et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in anymedium, provided the original author and source are credited.
DOI
10.1371/journal.pone.0144390
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의학전문대학원 > 의학과 > Journal papers
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