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Diagnostic delay in adult coeliac disease: An Italian multicentre study

Title: Diagnostic delay in adult coeliac disease: An Italian multicentre study
Authors: Lenti M. V.; Aronico N.; Bianchi P. I.; D'Agate C. C.; Neri M.; Volta U.; Mumolo M. G.; Astegiano M.; Calabro A. S.; Zingone F.; Latella G.; Di Sario A.; Carroccio A.; Ciacci C.; Luzza F.; Bagnato C.; Fantini M. C.; Elli L.; Cammarota G.; Gasbarrini A.; Portincasa P.; Latorre M. A.; Petrucci C.; Quatraccioni C.; Iannelli C.; Vecchione N.; Rossi C. M.; Broglio G.; Ianiro G.; Marsilio I.; Bibbo S.; Marinoni B.; Tomaselli D.; Abenavoli L.; Pilia R.; Santacroce G.; Lynch E.; Carrieri A.; Mansueto P.; Gabba M.; Alunno G.; Rossi C.; Onnis F.; Efthymakis K.; Cesaro N.; Vernero M.; Baiano Svizzero F.; Semeraro F. P.; Silano M.; Vanoli A.; Klersy C.; Corazza G. R.; Di Sabatino A.
Contributors: M.V. Lenti; N. Aronico; P.I. Bianchi; C.C. D'Agate; M. Neri; U. Volta; M.G. Mumolo; M. Astegiano; A.S. Calabro; F. Zingone; G. Latella; A. Di Sario; A. Carroccio; C. Ciacci; F. Luzza; C. Bagnato; M.C. Fantini; L. Elli; G. Cammarota; A. Gasbarrini; P. Portincasa; M.A. Latorre; C. Petrucci; C. Quatraccioni; C. Iannelli; N. Vecchione; C.M. Rossi; G. Broglio; G. Ianiro; I. Marsilio; S. Bibbo; B. Marinoni; D. Tomaselli; L. Abenavoli; R. Pilia; G. Santacroce; E. Lynch; A. Carrieri; P. Mansueto; M. Gabba; G. Alunno; C. Rossi; F. Onni; K. Efthymaki; N. Cesaro; M. Vernero; F. Baiano Svizzero; F.P. Semeraro; M. Silano; A. Vanoli; C. Klersy; G.R. Corazza; A. Di Sabatino
Publisher Information: Elsevier B.V.
Publication Year: 2023
Collection: The University of Milan: Archivio Istituzionale della Ricerca (AIR)
Subject Terms: Diagnosi; Enteropathy; Gluten; Malabsorption; Villi; Settore MEDS-10/A - Gastroenterologia
Description: Background: There are few data regarding the diagnostic delay and its predisposing factors in coeliac disease (CD). Aims: To investigate the overall, the patient-dependant, and the physician-dependant diagnostic delays in CD. Methods: CD adult patients were retrospectively enroled at 19 Italian CD outpatient clinics (2011–2021). Overall, patient-dependant, and physician-dependant diagnostic delays were assessed. Extreme diagnostic, i.e., lying above the third quartile of our population, was also analysed. Multivariable regression models for factors affecting the delay were fitted. Results: Overall, 2362 CD patients (median age at diagnosis 38 years, IQR 27–46; M:F ratio=1:3) were included. The median overall diagnostic delay was 8 months (IQR 5–14), while patient- and physician-dependant delays were 3 (IQR 2–6) and 4 (IQR 2–6) months, respectively. Previous misdiagnosis was associated with greater physician-dependant (1.076, p = 0.005) and overall (0.659, p = 0.001) diagnostic delays. Neurological symptoms (odds ratio 2.311, p = 0.005) and a previous misdiagnosis (coefficient 9.807, p = 0.000) were associated with a greater extreme physician-dependant delay. Gastrointestinal symptoms (OR 1.880, p = 0.004), neurological symptoms (OR 2.313, p = 0.042), and previous misdiagnosis (OR 4.265, p = 0.000) were associated with increased extreme overall diagnostic delay. Conclusion: We identified some factors that hamper CD diagnosis. A proper screening strategy for CD should be implemented.
Document Type: article in journal/newspaper
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/36567177; info:eu-repo/semantics/altIdentifier/wos/WOS:001023603600001; volume:55; issue:6; firstpage:743; lastpage:750; numberofpages:8; journal:DIGESTIVE AND LIVER DISEASE; https://hdl.handle.net/2434/1143595
DOI: 10.1016/j.dld.2022.11.021
Availability: https://hdl.handle.net/2434/1143595; https://doi.org/10.1016/j.dld.2022.11.021
Rights: info:eu-repo/semantics/closedAccess
Accession Number: edsbas.80000C81
Database: BASE