Clinical factors and disease course related to diagnostic delay in Korean Crohn's disease patients: Results from the CONNECT study

Chang Mo Moon, Sung Ae Jung, Seong Eun Kim, Hyun Joo Song, Yunho Jung, Byong Duk Ye, Jae Hee Cheon, You Sun Kim, Young Ho Kim, Joo Sung Kim, Dong Soo Han

Research output: Contribution to journalArticle

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Abstract

Diagnostic delay frequently occurs in Crohn's disease (CD) patients because of diagnostic limitations. However, diagnostic delay and its related factors remain poorly defined. Therefore, we aimed to identify the predictors associated with diagnostic delay and to evaluate the impact of diagnostic delay on clinical course in a Korean CD patient cohort. We performed a multicenter retrospective analysis of 1,047 CD patients registered in the Crohn's Disease Clinical Network and Cohort study in Korea. The mean interval of diagnostic delay was 16.0 ± 33.1 months. Multivariate analysis showed that older age at diagnosis (≥40 years) (p = 0.014), concomitant upper gastrointestinal (UGI) disease (p = 0.012) and penetrating disease behavior at diagnosis (p = 0.001) were positively associated with long diagnostic delay (≥18 months). During the longitudinal follow-up, long diagnostic delay was independently predictive of further development of intestinal stenosis (hazard ratio [HR], 1.43; 95% confidence interval [CI], 1.07-1.93; p = 0.017), internal fistulas (HR, 1.62; 95% CI, 1.12-2.33; p = 0.011), and perianal fistulas (HR, 1.38; 95% CI, 1.06-1.80; p = 0.016). However, as for the risk of abscess formation, bowel perforation, and CD-related abdominal surgery, no significant association with diagnostic delay was observed. Older age at diagnosis, UGI involvement, and penetrating behavior are associated with long diagnostic delay in Korean CD patients. Moreover, diagnostic delay is associated with an increased risk of CDrelated complications such as intestinal stenosis, internal fistulas, and perianal fistulas.

Original languageEnglish
Article numbere0144390
JournalPloS one
Volume10
Issue number12
DOIs
Publication statusPublished - 2015 Dec 1

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Crohn disease
disease course
Crohn Disease
fistula
Fistula
confidence interval
Confidence Intervals
Hazards
Pathologic Constriction
Gastrointestinal Diseases
abscess
Korea
digestive system diseases
cohort studies
Abscess
multivariate analysis
Korean Peninsula
Cohort Studies
Multivariate Analysis
surgery

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Moon, Chang Mo ; Jung, Sung Ae ; Kim, Seong Eun ; Song, Hyun Joo ; Jung, Yunho ; Ye, Byong Duk ; Cheon, Jae Hee ; Kim, You Sun ; Kim, Young Ho ; Kim, Joo Sung ; Han, Dong Soo. / Clinical factors and disease course related to diagnostic delay in Korean Crohn's disease patients : Results from the CONNECT study. In: PloS one. 2015 ; Vol. 10, No. 12.
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title = "Clinical factors and disease course related to diagnostic delay in Korean Crohn's disease patients: Results from the CONNECT study",
abstract = "Diagnostic delay frequently occurs in Crohn's disease (CD) patients because of diagnostic limitations. However, diagnostic delay and its related factors remain poorly defined. Therefore, we aimed to identify the predictors associated with diagnostic delay and to evaluate the impact of diagnostic delay on clinical course in a Korean CD patient cohort. We performed a multicenter retrospective analysis of 1,047 CD patients registered in the Crohn's Disease Clinical Network and Cohort study in Korea. The mean interval of diagnostic delay was 16.0 ± 33.1 months. Multivariate analysis showed that older age at diagnosis (≥40 years) (p = 0.014), concomitant upper gastrointestinal (UGI) disease (p = 0.012) and penetrating disease behavior at diagnosis (p = 0.001) were positively associated with long diagnostic delay (≥18 months). During the longitudinal follow-up, long diagnostic delay was independently predictive of further development of intestinal stenosis (hazard ratio [HR], 1.43; 95{\%} confidence interval [CI], 1.07-1.93; p = 0.017), internal fistulas (HR, 1.62; 95{\%} CI, 1.12-2.33; p = 0.011), and perianal fistulas (HR, 1.38; 95{\%} CI, 1.06-1.80; p = 0.016). However, as for the risk of abscess formation, bowel perforation, and CD-related abdominal surgery, no significant association with diagnostic delay was observed. Older age at diagnosis, UGI involvement, and penetrating behavior are associated with long diagnostic delay in Korean CD patients. Moreover, diagnostic delay is associated with an increased risk of CDrelated complications such as intestinal stenosis, internal fistulas, and perianal fistulas.",
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Moon, CM, Jung, SA, Kim, SE, Song, HJ, Jung, Y, Ye, BD, Cheon, JH, Kim, YS, Kim, YH, Kim, JS & Han, DS 2015, 'Clinical factors and disease course related to diagnostic delay in Korean Crohn's disease patients: Results from the CONNECT study', PloS one, vol. 10, no. 12, e0144390. https://doi.org/10.1371/journal.pone.0144390

Clinical factors and disease course related to diagnostic delay in Korean Crohn's disease patients : Results from the CONNECT study. / Moon, Chang Mo; Jung, Sung Ae; Kim, Seong Eun; Song, Hyun Joo; Jung, Yunho; Ye, Byong Duk; Cheon, Jae Hee; Kim, You Sun; Kim, Young Ho; Kim, Joo Sung; Han, Dong Soo.

In: PloS one, Vol. 10, No. 12, e0144390, 01.12.2015.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Clinical factors and disease course related to diagnostic delay in Korean Crohn's disease patients

T2 - Results from the CONNECT study

AU - Moon, Chang Mo

AU - Jung, Sung Ae

AU - Kim, Seong Eun

AU - Song, Hyun Joo

AU - Jung, Yunho

AU - Ye, Byong Duk

AU - Cheon, Jae Hee

AU - Kim, You Sun

AU - Kim, Young Ho

AU - Kim, Joo Sung

AU - Han, Dong Soo

PY - 2015/12/1

Y1 - 2015/12/1

N2 - Diagnostic delay frequently occurs in Crohn's disease (CD) patients because of diagnostic limitations. However, diagnostic delay and its related factors remain poorly defined. Therefore, we aimed to identify the predictors associated with diagnostic delay and to evaluate the impact of diagnostic delay on clinical course in a Korean CD patient cohort. We performed a multicenter retrospective analysis of 1,047 CD patients registered in the Crohn's Disease Clinical Network and Cohort study in Korea. The mean interval of diagnostic delay was 16.0 ± 33.1 months. Multivariate analysis showed that older age at diagnosis (≥40 years) (p = 0.014), concomitant upper gastrointestinal (UGI) disease (p = 0.012) and penetrating disease behavior at diagnosis (p = 0.001) were positively associated with long diagnostic delay (≥18 months). During the longitudinal follow-up, long diagnostic delay was independently predictive of further development of intestinal stenosis (hazard ratio [HR], 1.43; 95% confidence interval [CI], 1.07-1.93; p = 0.017), internal fistulas (HR, 1.62; 95% CI, 1.12-2.33; p = 0.011), and perianal fistulas (HR, 1.38; 95% CI, 1.06-1.80; p = 0.016). However, as for the risk of abscess formation, bowel perforation, and CD-related abdominal surgery, no significant association with diagnostic delay was observed. Older age at diagnosis, UGI involvement, and penetrating behavior are associated with long diagnostic delay in Korean CD patients. Moreover, diagnostic delay is associated with an increased risk of CDrelated complications such as intestinal stenosis, internal fistulas, and perianal fistulas.

AB - Diagnostic delay frequently occurs in Crohn's disease (CD) patients because of diagnostic limitations. However, diagnostic delay and its related factors remain poorly defined. Therefore, we aimed to identify the predictors associated with diagnostic delay and to evaluate the impact of diagnostic delay on clinical course in a Korean CD patient cohort. We performed a multicenter retrospective analysis of 1,047 CD patients registered in the Crohn's Disease Clinical Network and Cohort study in Korea. The mean interval of diagnostic delay was 16.0 ± 33.1 months. Multivariate analysis showed that older age at diagnosis (≥40 years) (p = 0.014), concomitant upper gastrointestinal (UGI) disease (p = 0.012) and penetrating disease behavior at diagnosis (p = 0.001) were positively associated with long diagnostic delay (≥18 months). During the longitudinal follow-up, long diagnostic delay was independently predictive of further development of intestinal stenosis (hazard ratio [HR], 1.43; 95% confidence interval [CI], 1.07-1.93; p = 0.017), internal fistulas (HR, 1.62; 95% CI, 1.12-2.33; p = 0.011), and perianal fistulas (HR, 1.38; 95% CI, 1.06-1.80; p = 0.016). However, as for the risk of abscess formation, bowel perforation, and CD-related abdominal surgery, no significant association with diagnostic delay was observed. Older age at diagnosis, UGI involvement, and penetrating behavior are associated with long diagnostic delay in Korean CD patients. Moreover, diagnostic delay is associated with an increased risk of CDrelated complications such as intestinal stenosis, internal fistulas, and perianal fistulas.

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