Childhood Onset Inflammatory Bowel Disease: Predictors of Delayed Diagnosis from the CEDATA German-Language Pediatric Inflammatory Bowel Disease Registry - 20/08/11

Doi : 10.1016/j.jpeds.2010.09.014

Antje Timmer, MD, MSc, PhD ^a,^b, Rolf Behrens, MD, PhD ^d, Stephan Buderus, MD ^e, Annette Findeisen, MD ^f, Almuthe Hauer, MD, PhD ^j, Klaus-Michael Keller, MD, PhD ^g, Guido Kliemann, MD ^g,^h, Thomas Lang, MD ⁱ, Wolfgang Lohr, CDM ^a, Peter Rzehak, PhD ^a, Sibylle Koletzko, MD, PhD ^c,^⁎
CEDATA-GPGE Study Group
List of members of the CEDATA-GPGE Study Group available at www.jpeds.com (Appendix).
^a HelmholtzZentrum München, German Research Centre for Health and Environment, Department of Epidemiology, Neuherberg, Germany
^b Institute of Medical Data Management, Biometrics and Epidemiology, Ludwig Maximilians University, Munich, Germany
^c Dr. von Haunersches Kinderspital, Ludwig Maximilians University, Munich, Germany
^d Centre for Neonatal, Child and Adolescent Care, Klinikum Süd, Nuremberg, Germany
^e Department of Paediatrics, St. Marien Hospital, Bonn, Germany
^f Department of Paediatrics and Adolescent Medicine, Ernst-Moritz-Arndt-University, Greifswald, Germany
^g Paediatric Department, Deutsche Klinik für Diagnostik, Wiesbaden, Germany
^h Department of Paediatrics and Neonatology, University Hospital, Giessen, Germany
ⁱ Klinik St. Hedwig, University Children's Hospital, Regensburg, Germany
^j Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria

Reprint request: Sibylle Koletzko, Dr. von Haunersches Kinderspital, Klinikum der Universität München. Lindwurmstraβe 4, D-80337 München, Germany.

Abstract

Objectives

To examine predictors of delayed diagnosis of inflammatory bowel disease in children and adolescents.

Study design

A total of 2436 patients (age 0–18 years) with Crohn’s disease, ulcerative colitis, or unclassified colitis were included from 53 pediatric gastroenterologists. Predictors were examined with the proportional hazards model, presented as hazard ratios (HR) with 95% confidence intervals. HR < 1.0 represent factors associated with late diagnosis.

Results

Median time to diagnosis was 4 (2-8) months. Crohn’s disease (HR 0.62; 0.56–0.68), and within Crohn’s disease, ileal disease (HR 0.77, 95% confidence interval 0.67 to 0.89) were associated with delayed diagnosis. Chances for early diagnosis increased with increasing age (HR 1.07 per year of age; 1.06 to 1.08). There was also an effect by center (HR 0.63, 0.52 to 0.67), but not by sex or country (Austria vs Germany). Growth failure was more common in those cases with delayed diagnosis.

Conclusions

There is still concern about delays in the diagnosis of inflammatory bowel disease in the very young and in children with small bowel disease. Inequalities of care by region require further investigation.

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Mots-clés : CEDATA, E, ESPGHAN, GPGE, HR, IBD, L

Plan

Supported by Bild hilft e.V. EIN HERZ FÜR KINDER, Hamburg; Falk Foundation, Freiburg; SHS Gesellschaft für klinische Ernährung mbH, Heilbronn; Society of Pediatric Gastroenterology and Nutrition (GPGE). The authors declare no conflicts of interest.

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Vol 158 - N° 3

P. 467 - mars 2011 Retour au numéro

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Childhood Onset Inflammatory Bowel Disease: Predictors of Delayed Diagnosis from the CEDATA German-Language Pediatric Inflammatory Bowel Disease Registry - 20/08/11

Abstract

Objectives

Study design

Results

Conclusions

Plan

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