Abstract
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.
Keywords
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Article info
Publication history
Published online: December 23, 2022
Accepted:
November 29,
2022
Received:
August 24,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
