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* = Presenting author

P277 S. Jiménez*1, V.M. Navas2, J. Martín-De-Carpi3, A. Rodríguez4, S. López-Cuesta5, Ó. Segarra6, J.I. García-Burriel7, E. Donat8, J. Barrio9, V. Crujeiras10, H. Armas11, L. Ortigosa12, R. García-Romero13,

1Hospital Universitario Central de Asturias, Paediatric Gastroenterology and Nutrition Unit, Oviedo, Spain, 2Hospital Regional Universitario Carlos Haya, Málaga, Paediatric Gastroenterology and Nutrition Unit, Málaga, Spain, 3Hospital Sant Joan de Déu, Paediatric IBD Unit, Barcelona, Spain, 4Hospital Universitario Virgen Del Rocio, Paediatric Gastroenterology and Nutrition Unit, Sevilla, Spain, 5Hospital Universitario Donostia, Paediatric Gastroenterology and Nutrition Unit, San Sebastián, Spain, 6Hospital Universitari Vall d'Hebron, Paediatric Gastroenterology and Nutrition Unit, Barcelona, Spain, 7Complexo Hospitalario Universitario de Vigo, Paediatric Gastroenterology and Nutrition Unit, Vigo, Spain, 8Hospital Universitari I Politècnic La Fe, Paediatric Gastroenterology and Nutrition Unit, Valencia, Spain, 9Hospital Universitario de Fuenlabrada, Paediatric Gastroenterology and Nutrition Unit, Fuenlabrada, Spain, 10Hospital Clínico Universitario de Santiago, Paediatric Gastroenterology and Nutrition Unit, Santiago de Compostela, Spain, 11Hospital Universitario de Canarias, Paediatric Gastroenterology and Nutrition Unit, La Laguna, SantaCruz de Tenerife, Spain, 12Hospital Nuestra Sra de Candelaria, Paediatric Gastroenterology and Nutrition Unit, Santa Cruz de Tenerife, Spain, 13Hospital Universitario Miguel Servet, Paediatric Gastroenterology and Nutrition Unit, Zaragoza, Spain, 14Hospital Universitario de Basurto, Paediatric Gastroenterology and Nutrition Unit, Bilbao, Spain, 15Hospital Univesrsitario de Álava-Txagorritxu, Paediatric Gastroenterology and Nutrition Unit, Vitoria, Spain, 16Hospital San Pedro de Alcántara, Paediatric Gastroenterology and Nutrition Unit, Cáceres, Spain, 17Hospital de Mendaro, Paediatric Gastroenterology and Nutrition Unit, Mendaro, Spain, 18Hospital Virgen de la Concha, Paediatric Gastroenterology and Nutrition Unit, Zamora, Spain, 19Complejo Hospitalario Río Carrión, Paediatric Gastroenterology and Nutrition Unit, Palencia, Spain, 20Hospital Universitario Infanta Elena, Paediatric Gastroenterology and Nutrition Unit, Valdemoro, Spain

Background

Diagnostic delay (DD) in Inflammatory Bowel Disease (IBD) has important clinical impact. There is increasing evidence showing a higher success rate when treatment is administered early in the disease

Objective: To evaluate DD in paediatric IBD in Spain.

Methods

Multicentric prospective observational study including paediatric IBD patients diagnosed in 2013 and 2014 in 20 paediatric centers. Data from 18 months were analyzed. Information was obtained from a questionnaire filled in by the treating paediatric gastroenterologist. Data were analyzed with the program SPSS 18.

Results

Data from 80 patients (51 males) were obtained. Mean age at diagnosis was 11.24 years (95% Confidence Interval 10.55-11.92). Disease distribution: Crohn's disease (CD) 50 patients (62.5%), ulcerative colitis (UC) 27(33.8%), IBD unclassified (IBDU) 3 (3.8%). Median DD was 19.64 weeks (interquartile range[IQR] 37.46), being significantly longer (p=0,005) in CD (27.85 w; IQR 39.71) than in UC (16.57 w; IQR 18.54). Family IBD history was not associated with shorter DD. Median time from appearance of symptoms to consultation with the first physician involved in the process was 2 weeks (IQR 4.07), from this first visit to being sent to the paediatric gastroenterologist(PG)7.3 weeks (IQR 20.71); from referral to the PG visit 0.93 weeks (IQR 4.14), and from this visit to the diagnosis 2 weeks (IQR 5.18). The time span from the first physician consultation (FPC) to the PG referral was significantly longer in CD (10.43w, IQR35.29) than in UC(3.78w, IQR 6.54). It was also significantly longer the time interval from the FPC to the final diagnosis in CD (18.57w, IQR 38.21 ) than in UC (9.18w, IQR18). There were no differences in the rest of the time intervals. The median of physicians visited before the PG was 2(IQR 2), but 25.6% of patients went to 3 or more physicians. A negative correlation between the DD and the z-score for height in CD patients was observed(r=-0.36, p=0.015)

Conclusion

DD in CD was significantly longer as compared to UC. The major component responsible for DD in IBD was the time spent between the FPC and the PG referral. A significantly negative correlation was found between the DD and the z-score for height in CD patients.