دورية أكاديمية
Factors associated with diagnostic delay in axial spondyloarthritis: impact of clinical factors and social vulnerability
| العنوان: | Factors associated with diagnostic delay in axial spondyloarthritis: impact of clinical factors and social vulnerability |
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| المؤلفون: | McDermott, Gregory C., Monshadizeh, Armaan, Selzer, Faith, Zhao, Sizheng S., Ermann, Joerg, Katz, Jeffrey N. |
| المصدر: | McDermott , G C , Monshadizeh , A , Selzer , F , Zhao , S S , Ermann , J & Katz , J N 2024 , ' Factors associated with diagnostic delay in axial spondyloarthritis: impact of clinical factors and social vulnerability ' , Arthritis Care & Research , vol. 76 , no. 4 , pp. 541-549 . https://doi.org/10.1002/acr.25264Test |
| سنة النشر: | 2024 |
| المجموعة: | The University of Manchester: Research Explorer - Publications |
| مصطلحات موضوعية: | axial spondyloarthritis, diagnostic delay, uveitis |
| الوصف: | Objective: Axial spondyloarthritis (axSpA) patients often experience significant delay between symptom onset and diagnosis. Determinants of delay are incompletely understood. We investigated associations between demographic, medical, and socioeconomic factors and axSpA diagnostic delay. Methods: We identified axSpA patients diagnosed by rheumatologists in the Mass General Brigham health care system between December 1990 and October 2021. All patients met modified New York criteria for ankylosing spondylitis (AS) or 2009 Assessment of SpondloArthritis international Society (ASAS) criteria for axSpA. We determined the duration of diagnostic delay, defined as the duration of back pain symptoms reported at diagnosis, as well as extra-articular disease manifestations and specialty care received prior to diagnosis from the electronic health record. We obtained each patient’s social vulnerability index (SVI) by mapping their address to the US Centers for Disease Control SVI Atlas. We examined associations between disease manifestations, SVI, and diagnostic delay using ordinal logistic regression. Results: We identified 554 axSpA patients with mean diagnostic delay 6.8 (SD 8.5) years. In multivariable ordinal logistic regression analyses, peripheral arthritis (OR 0.65, 95%CI 0.45-0.93) and older age at symptom onset (OR 0.83, 95%CI 0.78-0.88 per 5 years) were associated with shorter delay. AS at diagnosis (OR 1.85, 95%CI 1.30-2.63), having a history of uveitis prior to diagnosis (OR 2.77, 95%CI 1.73-4.52), and higher social vulnerability (defined as being in the 80-99th percentile of SVI – OR 1.99, 95%CI 1.06-3.84) were associated with longer diagnostic delay. Conclusion: Older age at back pain onset and peripheral arthritis were associated with shorter delay while uveitis was associated with longer diagnostic delay. Patients with higher socioeconomic vulnerability had longer diagnostic delay independent of clinical factors. |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| اللغة: | English |
| العلاقة: | https://research.manchester.ac.uk/en/publications/d0a4aea8-b9f2-4f29-99de-350c9741d068Test |
| DOI: | 10.1002/acr.25264 |
| الإتاحة: | https://doi.org/10.1002/acr.25264Test https://research.manchester.ac.uk/en/publications/d0a4aea8-b9f2-4f29-99de-350c9741d068Test https://pure.manchester.ac.uk/ws/files/278740331/axspa_diagnostic_delay.docxTest |
| حقوق: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.3382DE4A |
| قاعدة البيانات: | BASE |
| DOI: | 10.1002/acr.25264 |
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