• Antje Timmer, Rolf Behrens, Stephan Buderus, Annette Findeisen, Almuthe Hauer, Klaus-Michael Keller, Guido Kliemann, Thomas Lang, Wolfgang Lohr, Peter Rzehak, Sibylle Koletzko, and CEDATA-GPGE Study Group.
• HelmholtzZentrum München, German Research Centre for Health and Environment, Department of Epidemiology, Neuherberg, Germany.
• J. Pediatr. 2011 Mar 1; 158 (3): 467-473.e2.

ObjectivesTo examine predictors of delayed diagnosis of inflammatory bowel disease in children and adolescents.Study DesignA total of 2,436 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.ResultsMedian 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.ConclusionsThere 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.Copyright © 2011. Published by Mosby, Inc.

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