Diagnostic delay in symptomatic uncomplicated diverticular disease: an Italian tertiary referral centre study

• Published in: Internal and emergency medicine 2024-01, Vol.19 (1), p.99-106
• Main Authors: Santacroce, Giovanni, Lenti, Marco Vincenzo, Abruzzese, Giulia Maria, Alunno, Giacomo, Di Terlizzi, Francesco, Frenna, Carmine, Gentile, Antonella, Latorre, Mario Andrea, Petrucci, Clarissa, Ruggeri, Damiano, Soriano, Simone, Aronico, Nicola, Rossi, Carlo Maria, De Silvestri, Annalisa, Corazza, Gino Roberto, Di Sabatino, Antonio
• Format: Article
• Language: English
• Subjects: Im - Original; Internal Medicine; Irritable bowel syndrome; Medical referrals; Medicine; Medicine & Public Health; Multivariate analysis; Patients; Risk factors
• ISSN: 1828-0447; 1970-9366; 1970-9366
• DOI: 10.1007/s11739-023-03446-x

The magnitude of the diagnostic delay of symptomatic uncomplicated diverticular disease (SUDD) is unknown; we aimed to evaluate SUDD diagnostic delay and its risk factors. SUDD patients diagnosed at a tertiary referral centre were retrospectively enrolled (2010–2022). Demographic and clinical data were retrieved. Overall, patient-, and physician-dependant diagnostic delays were assessed. Univariate and multivariate analyses were fitted to identify risk factors for diagnostic delay. Overall, 70 SUDD patients (median age 65 years, IQR 52–74; F:M ratio = 1.6:1) were assessed. The median overall diagnostic delay was 7 months (IQR 2–24), patient-dependant delay was 3 months (IQR 0–15), and physician-dependant delay was 1 month (IQR 0–6). Further, 25% of patients were misdiagnosed with irritable bowel syndrome (IBS). At multivariate analysis, previous misdiagnosis was a significant risk factor for overall and physician-dependant diagnostic delay (OR 9.99, p = 0.01, and OR 6.46, p = 0.02, respectively). Also, a high educational level (> 13 years) was associated with a greater overall diagnostic delay (OR 8.74 p = 0.02), while previous abdominal surgery was significantly associated to reduced physician-dependant diagnostic delay (OR 0.19 p = 0.04). To conclude, SUDD may be diagnosed late, IBS being the most frequent misdiagnosis. Timely diagnosis is crucial to tackle the burden of SUDD on patients and healthcare.