Diagnostic delay and misdiagnosis in eosinophilic oesophagitis
Eosinophilic oesophagitis (EoE) may lead to severe complications if not promptly recognised. To assess the diagnostic delay in patients with EoE and to explore its risk factors. EoE patients followed-up at eight clinics were included via retrospective chart review. Diagnostic delay was estimated as...
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| Veröffentlicht in: | Digestive and liver disease 2021-12, Vol.53 (12), p.1632-1639 |
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| creator | Lenti, Marco Vincenzo Savarino, Edoardo Mauro, Aurelio Penagini, Roberto Racca, Francesca Ghisa, Matteo Laserra, Giorgio Merli, Stefania Arsiè, Elena Longoni, Valeria de Bortoli, Nicola Sostilio, Andrea Marabotto, Elisa Ziola, Sebastiano Vanoli, Alessandro Zingone, Fabiana Barberio, Brigida Tolone, Salvatore Docimo, Ludovico Pellegatta, Gaia Paoletti, Giovanni Ribolsi, Mentore Repici, Alessandro Klersy, Catherine Di Sabatino, Antonio |
| description | Eosinophilic oesophagitis (EoE) may lead to severe complications if not promptly recognised.
To assess the diagnostic delay in patients with EoE and to explore its risk factors.
EoE patients followed-up at eight clinics were included via retrospective chart review. Diagnostic delay was estimated as the time lapse occurring between the appearance of the first likely symptoms indicative of EoE and the final diagnosis. Patient-dependent and physician-dependent diagnostic delays were assessed. Multivariable regression models were computed.
261 patients with EoE (mean age 34±14 years; M:F ratio=3:1) were included. The median overall diagnostic delay was 36 months (IQR 12-88), while patient- and physician-dependent diagnostic delays were 18 months (IQR 5-49) and 6 months (IQR 1-24). Patient-dependent delay was greater compared to physician-dependent delay (95% CI 5.1-19.3, p1 episode of food impaction, previous endoscopy with no biopsies, regurgitation, and ≥2 assessing physicians. Being single was significantly associated with lower overall and patient-dependent diagnostic delay.
EoE is burdened by substantial diagnostic delay, depending on both patient-related and physician-related factors. |
| doi_str_mv | 10.1016/j.dld.2021.05.017 |
| format | Article |
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To assess the diagnostic delay in patients with EoE and to explore its risk factors.
EoE patients followed-up at eight clinics were included via retrospective chart review. Diagnostic delay was estimated as the time lapse occurring between the appearance of the first likely symptoms indicative of EoE and the final diagnosis. Patient-dependent and physician-dependent diagnostic delays were assessed. Multivariable regression models were computed.
261 patients with EoE (mean age 34±14 years; M:F ratio=3:1) were included. The median overall diagnostic delay was 36 months (IQR 12-88), while patient- and physician-dependent diagnostic delays were 18 months (IQR 5-49) and 6 months (IQR 1-24). Patient-dependent delay was greater compared to physician-dependent delay (95% CI 5.1-19.3, p<0.001). A previous misdiagnosis was formulated in 109 cases (41.8%; gastro-oesophageal reflux disease in 67 patients, 25.7%). The variables significantly associated with greater overall diagnostic delay were being a non-smoker, >1 episode of food impaction, previous endoscopy with no biopsies, regurgitation, and ≥2 assessing physicians. Being single was significantly associated with lower overall and patient-dependent diagnostic delay.
EoE is burdened by substantial diagnostic delay, depending on both patient-related and physician-related factors.</description><identifier>ISSN: 1590-8658</identifier><identifier>EISSN: 1878-3562</identifier><identifier>DOI: 10.1016/j.dld.2021.05.017</identifier><identifier>PMID: 34116974</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Adult ; Age Distribution ; Delayed Diagnosis - statistics & numerical data ; Diagnostic Errors - statistics & numerical data ; dysphagia ; Eosinophilic Esophagitis - diagnosis ; Eosinophilic Esophagitis - epidemiology ; Eosinophilic Esophagitis - physiopathology ; eosinophils ; Female ; food impaction ; gastro-oesophageal reflux disease ; Humans ; Male ; Middle Aged ; oesophagus ; Retrospective Studies ; Young Adult</subject><ispartof>Digestive and liver disease, 2021-12, Vol.53 (12), p.1632-1639</ispartof><rights>2021</rights><rights>Copyright © 2021. Published by Elsevier Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c353t-b3727c5566dd16e573a99175ae9c1025f9089506e9796595ac1c63520dc18f253</citedby><cites>FETCH-LOGICAL-c353t-b3727c5566dd16e573a99175ae9c1025f9089506e9796595ac1c63520dc18f253</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.dld.2021.05.017$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,45974</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34116974$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lenti, Marco Vincenzo</creatorcontrib><creatorcontrib>Savarino, Edoardo</creatorcontrib><creatorcontrib>Mauro, Aurelio</creatorcontrib><creatorcontrib>Penagini, Roberto</creatorcontrib><creatorcontrib>Racca, Francesca</creatorcontrib><creatorcontrib>Ghisa, Matteo</creatorcontrib><creatorcontrib>Laserra, Giorgio</creatorcontrib><creatorcontrib>Merli, Stefania</creatorcontrib><creatorcontrib>Arsiè, Elena</creatorcontrib><creatorcontrib>Longoni, Valeria</creatorcontrib><creatorcontrib>de Bortoli, Nicola</creatorcontrib><creatorcontrib>Sostilio, Andrea</creatorcontrib><creatorcontrib>Marabotto, Elisa</creatorcontrib><creatorcontrib>Ziola, Sebastiano</creatorcontrib><creatorcontrib>Vanoli, Alessandro</creatorcontrib><creatorcontrib>Zingone, Fabiana</creatorcontrib><creatorcontrib>Barberio, Brigida</creatorcontrib><creatorcontrib>Tolone, Salvatore</creatorcontrib><creatorcontrib>Docimo, Ludovico</creatorcontrib><creatorcontrib>Pellegatta, Gaia</creatorcontrib><creatorcontrib>Paoletti, Giovanni</creatorcontrib><creatorcontrib>Ribolsi, Mentore</creatorcontrib><creatorcontrib>Repici, Alessandro</creatorcontrib><creatorcontrib>Klersy, Catherine</creatorcontrib><creatorcontrib>Di Sabatino, Antonio</creatorcontrib><title>Diagnostic delay and misdiagnosis in eosinophilic oesophagitis</title><title>Digestive and liver disease</title><addtitle>Dig Liver Dis</addtitle><description>Eosinophilic oesophagitis (EoE) may lead to severe complications if not promptly recognised.
To assess the diagnostic delay in patients with EoE and to explore its risk factors.
EoE patients followed-up at eight clinics were included via retrospective chart review. Diagnostic delay was estimated as the time lapse occurring between the appearance of the first likely symptoms indicative of EoE and the final diagnosis. Patient-dependent and physician-dependent diagnostic delays were assessed. Multivariable regression models were computed.
261 patients with EoE (mean age 34±14 years; M:F ratio=3:1) were included. The median overall diagnostic delay was 36 months (IQR 12-88), while patient- and physician-dependent diagnostic delays were 18 months (IQR 5-49) and 6 months (IQR 1-24). Patient-dependent delay was greater compared to physician-dependent delay (95% CI 5.1-19.3, p<0.001). A previous misdiagnosis was formulated in 109 cases (41.8%; gastro-oesophageal reflux disease in 67 patients, 25.7%). The variables significantly associated with greater overall diagnostic delay were being a non-smoker, >1 episode of food impaction, previous endoscopy with no biopsies, regurgitation, and ≥2 assessing physicians. Being single was significantly associated with lower overall and patient-dependent diagnostic delay.
EoE is burdened by substantial diagnostic delay, depending on both patient-related and physician-related factors.</description><subject>Adult</subject><subject>Age Distribution</subject><subject>Delayed Diagnosis - statistics & numerical data</subject><subject>Diagnostic Errors - statistics & numerical data</subject><subject>dysphagia</subject><subject>Eosinophilic Esophagitis - diagnosis</subject><subject>Eosinophilic Esophagitis - epidemiology</subject><subject>Eosinophilic Esophagitis - physiopathology</subject><subject>eosinophils</subject><subject>Female</subject><subject>food impaction</subject><subject>gastro-oesophageal reflux disease</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>oesophagus</subject><subject>Retrospective Studies</subject><subject>Young Adult</subject><issn>1590-8658</issn><issn>1878-3562</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1LAzEQhoMotlZ_gBfZo5ddM7udZIMgSP2Eghc9hzSZrSnb3brZCv33pmz16Ckv4ZmXmYexS-AZcBA3q8zVLst5DhnHjIM8YmMoZZkWKPLjmFHxtBRYjthZCCseQYH8lI2KKYBQcjpmdw_eLJs29N4mjmqzS0zjkrUPbvj3IfFNQjE07ebT1xFrKcRolr734ZydVKYOdHF4J-zj6fF99pLO355fZ_fz1BZY9OmikLm0iEI4B4JQFkYpkGhIWeA5VoqXCrkgJZVAhcaCFQXm3FkoqxyLCbseejdd-7Wl0Ou4oqW6Ng2126BznHIECUpEFAbUdm0IHVV60_m16XYauN5r0ysdtem9Ns1RR21x5upQv12syf1N_HqKwO0AUDzy21Ong_XUWHK-I9tr1_p_6n8A0P98Dw</recordid><startdate>202112</startdate><enddate>202112</enddate><creator>Lenti, Marco Vincenzo</creator><creator>Savarino, Edoardo</creator><creator>Mauro, Aurelio</creator><creator>Penagini, Roberto</creator><creator>Racca, Francesca</creator><creator>Ghisa, Matteo</creator><creator>Laserra, Giorgio</creator><creator>Merli, Stefania</creator><creator>Arsiè, Elena</creator><creator>Longoni, Valeria</creator><creator>de Bortoli, Nicola</creator><creator>Sostilio, Andrea</creator><creator>Marabotto, Elisa</creator><creator>Ziola, Sebastiano</creator><creator>Vanoli, Alessandro</creator><creator>Zingone, Fabiana</creator><creator>Barberio, Brigida</creator><creator>Tolone, Salvatore</creator><creator>Docimo, Ludovico</creator><creator>Pellegatta, Gaia</creator><creator>Paoletti, Giovanni</creator><creator>Ribolsi, Mentore</creator><creator>Repici, Alessandro</creator><creator>Klersy, Catherine</creator><creator>Di Sabatino, Antonio</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202112</creationdate><title>Diagnostic delay and misdiagnosis in eosinophilic oesophagitis</title><author>Lenti, Marco Vincenzo ; 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To assess the diagnostic delay in patients with EoE and to explore its risk factors.
EoE patients followed-up at eight clinics were included via retrospective chart review. Diagnostic delay was estimated as the time lapse occurring between the appearance of the first likely symptoms indicative of EoE and the final diagnosis. Patient-dependent and physician-dependent diagnostic delays were assessed. Multivariable regression models were computed.
261 patients with EoE (mean age 34±14 years; M:F ratio=3:1) were included. The median overall diagnostic delay was 36 months (IQR 12-88), while patient- and physician-dependent diagnostic delays were 18 months (IQR 5-49) and 6 months (IQR 1-24). Patient-dependent delay was greater compared to physician-dependent delay (95% CI 5.1-19.3, p<0.001). A previous misdiagnosis was formulated in 109 cases (41.8%; gastro-oesophageal reflux disease in 67 patients, 25.7%). The variables significantly associated with greater overall diagnostic delay were being a non-smoker, >1 episode of food impaction, previous endoscopy with no biopsies, regurgitation, and ≥2 assessing physicians. Being single was significantly associated with lower overall and patient-dependent diagnostic delay.
EoE is burdened by substantial diagnostic delay, depending on both patient-related and physician-related factors.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>34116974</pmid><doi>10.1016/j.dld.2021.05.017</doi><tpages>8</tpages></addata></record> |
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| subjects | Adult Age Distribution Delayed Diagnosis - statistics & numerical data Diagnostic Errors - statistics & numerical data dysphagia Eosinophilic Esophagitis - diagnosis Eosinophilic Esophagitis - epidemiology Eosinophilic Esophagitis - physiopathology eosinophils Female food impaction gastro-oesophageal reflux disease Humans Male Middle Aged oesophagus Retrospective Studies Young Adult |
| title | Diagnostic delay and misdiagnosis in eosinophilic oesophagitis |
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