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P233 Diagnostic delay in a large cohort of patients with inflammatory bowel disease – results of a multicenter study of the Austrian IBD Study Group (ATISG)

Novacek G.*1, Gröchenig H.P.2, Waldhör T.3, Eckhardt G.4, Feichtenschlager T.5, Haas T.6, Kirchgatterer A.7, Koch R.8, Ludwiczek O.9, Mayer A.10, Miehsler W.11, Papay P.12, Peters P.13, Platzer R.14, Reicht G.15, Steiner P.16, Wenzl H.17, Fuchssteiner H.18, Gartner J.19, Vogelsang H.1, Dejaco C.1

1Medical University of Vienna, Department of Internal Medicine III, Vienna, Austria 2Hospital Barmherzige Brüder St. Veit an der Glan, Department of Internal Medicine, St. Veit an der Glan, Austria 3Medical University of Vienna, Department of Epidemiology, Vienna, Austria 4Hospital Oberpullendorf, Department of Internal Medicine, Oberpullendorf, Austria 5Hospital Rudolfstiftung, Department of Internal Medicine IV, Vienna, Austria 6Darmpraxis Salzburg, Salzburg, Austria 7Hospital Wels-Grieskirchen, Department of Internal Medicine V, Grieskirchen, Austria 8Medical University of Innsbruck, Department of Internal Medicine I, Innsbruck, Austria 9Hospital Hall in Tirol, Department of Internal Medicine, Hall in Tirol, Austria 10Universitätsklinikum St. Pölten, Department of Internal Medicine II, St. Pölten, Austria 11Hospital Barmherzige Brüder Salzburg, Department of Internal Medicine, Salzburg, Austria 12Hartmannspital, Department of Internal Medicine, Vienna, Austria 13Hospital Feldkirch, Department of Internal Medicine, Feldkirch, Austria 14Hospital Wiener Neustadt, Department of Internal Medicine I, Wiener Neustadt, Austria 15Hospital Barmherzige Brüder Graz, Department of Internal Medicine, Graz, Austria 16Hospital Wels-Grieskirchen, Department of Internal Medicine I, Wels, Austria 17Medical University of Graz, Department of Gastroenterology & Hepatology, Graz, Austria 18Hospital Elisabethinen Linz, Department of Internal Medicine IV, Linz, Austria 19Hanusch Hospital, Department of Internal Medicine, Vienna, Austria

Background

Long diagnostic delay is frequent in inflammatory bowel disease (IBD), especially in Crohn's disease (CD), and may lead to irreversible bowel damage. We sought to investigate the diagnostic delay in a large cohort of Austrian IBD patients.

Methods

In a multicentre cohort study adult patients with IBD (Crohn's disease CD, ulcerative colitis UC, inflammatory bowel disease unclassified IBDU) attending 18 Austrian outpatient clinics were recruited between May 2014 and July 2015 to complete a multi-item questionnaire. Medical and socioeconomic chararteristics including diagnostic delay were recorded by that questionnaire. Diagnostic delay was defined as the time period from the first symptom onset to diagnosis of IBD. The survey preparation, data capturing and exploraratory data analysis were performed by using EvaSys software and SPSS.

Results

1218 patients (792 with CD, 405 with UC, 21 with IBDU; 617 women) with a mean age at the time of investigation of 41.5 years (range 18–87 years) and a mean duration of disease of 12.4 years (range 0–49 years) were analyzed. Patients with IBDU were included in the UC group. The median diagnostic delay in patients with CD was 0.53 years (95% confidence interval (CI) 0.45–0.61 years) and in patients with UC/IBDU was 0.28 years (95% CI 0.28–0.36 years) (p<0.001). The probability to be diagnosed with IBD after first symptom onset is given in Figure 1.

Figure 1. Time to diagnosis by type of disease.

Conclusion

In this large Austrian referral center based IBD cohort the diagnostic delay was significantly longer in CD than in UC/IBDU. The median diagnostic delay was 6 months in CD patients and 3 months in UC/IBDU patients.