Diagnostic Delay of Multiple Sclerosis in a Portuguese Population
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11187 |
Resumo: | Introduction: Multiple sclerosis is a chronic inflammatory disease, in which a diagnostic delay could reduce the available therapeutic options. Therefore, it is important to monitor the time to diagnosis and understand factors that may potentially reduce it. The objective of this study was to determine the time between the first symptoms and the diagnosis of multiple sclerosis and which factors may contribute to a diagnostic delay.Material and Methods: Cross-sectional multicenter study, with retrospective data analysis, conducted in five tertiary Portuguese hospitals. Patients were consecutively selected from each local multiple sclerosis patients´ database. Sociodemographic and initial clinical data were collected through a questionnaire. Date of final diagnosis and multiple sclerosis classification was obtained from clinical files.Results: A total of 285 patients were included with mean age at diagnosis of 36 years. The median time between first clinical manifestation and multiple sclerosis diagnosis was nine months (IQR 2 - 38). Diagnostic delay was associated with an older age (p < 0.001; r = 0.35), motor deficit at onset [26.5 months (IQR 4.5 - 56.5); p = 0.0005], higher number of relapses before diagnosis (p < 0.001; r = 0,626), first observation by other medical specialty [11 months (IQR 2 - 48); p < 0.001], prior alternative diagnosis [20 months (IQR 4 - 67.5); p < 0.001] and primary progressive subtype [37 months (IQR 25 - 64.5); p < 0.001]. The most significant delay occurred between the initial symptom and neurological observation.Discussion: A significant delay occurred between initial symptoms and the diagnosis of multiple sclerosis, reflecting the need toincrease awareness of this entity and its diverse symptom presentation. |
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Diagnostic Delay of Multiple Sclerosis in a Portuguese PopulationAtraso no Diagnóstico de Esclerose Múltipla numa População PortuguesaAge at OnsetDelayed DiagnosisMultiple SclerosisReferral and ConsultationDiagnóstico TardioEncaminhamento e ConsultaEsclerose MúltiplaIdade de InícioIntroduction: Multiple sclerosis is a chronic inflammatory disease, in which a diagnostic delay could reduce the available therapeutic options. Therefore, it is important to monitor the time to diagnosis and understand factors that may potentially reduce it. The objective of this study was to determine the time between the first symptoms and the diagnosis of multiple sclerosis and which factors may contribute to a diagnostic delay.Material and Methods: Cross-sectional multicenter study, with retrospective data analysis, conducted in five tertiary Portuguese hospitals. Patients were consecutively selected from each local multiple sclerosis patients´ database. Sociodemographic and initial clinical data were collected through a questionnaire. Date of final diagnosis and multiple sclerosis classification was obtained from clinical files.Results: A total of 285 patients were included with mean age at diagnosis of 36 years. The median time between first clinical manifestation and multiple sclerosis diagnosis was nine months (IQR 2 - 38). Diagnostic delay was associated with an older age (p < 0.001; r = 0.35), motor deficit at onset [26.5 months (IQR 4.5 - 56.5); p = 0.0005], higher number of relapses before diagnosis (p < 0.001; r = 0,626), first observation by other medical specialty [11 months (IQR 2 - 48); p < 0.001], prior alternative diagnosis [20 months (IQR 4 - 67.5); p < 0.001] and primary progressive subtype [37 months (IQR 25 - 64.5); p < 0.001]. The most significant delay occurred between the initial symptom and neurological observation.Discussion: A significant delay occurred between initial symptoms and the diagnosis of multiple sclerosis, reflecting the need toincrease awareness of this entity and its diverse symptom presentation.Introdução: A esclerose múltipla é uma doença inflamatória crónica na qual um atraso no diagnóstico poderá reduzir as opções terapêuticas, sendo importante monitorizar o tempo até ao diagnóstico e compreender os fatores que potencialmente o reduzam. Foi objetivo deste estudo determinar o tempo entre os primeiros sintomas e o diagnóstico de esclerose múltipla e quais os fatores que podem contribuir para o atraso no diagnóstico.Material e Métodos: Estudo multicêntrico transversal retrospetivo, realizado em cinco hospitais portugueses. Os doentes foram selecionados, consecutivamente, a partir de bases de dados locais. Os dados sociodemográficos e clínicos iniciais foram adquiridos através de questionário individual. A data do diagnóstico final e a classificação da esclerose múltipla foram obtidas por consulta do processo clínico.Resultados: Foram incluídos 285 doentes com média de idade ao diagnóstico de 36 anos. A mediana do tempo entre a primeira manifestação clínica e o diagnóstico foi de nove meses (IQR 2 - 38). O atraso no diagnóstico foi associado a idade avançada (p < 0,001; r = 0,35), défice motor inicial [26,5 meses (IQR 4,5 - 56,5), p = 0,0005], maior número de surtos previamente ao diagnóstico (p < 0,001; r = 0,626), primeira observação por outra especialidade médica [11 meses (IQR 2 - 48); p < 0,001], diagnóstico prévio alternativo [20 meses (IQR 4 - 67,5); p < 0,001] e esclerose múltipla primária progressiva [37 meses (IQR 25 - 64,5), p < 0,001]. O atraso mais significativo ocorreu entre o primeiro sintoma e a observação por neurologista.Discussão: Ocorreu um atraso significativo entre o primeiro sintoma e o diagnóstico de esclerose múltipla, refletindo uma necessidade de maior acuidade na identificação dos seus principais sintomas.Ordem dos Médicos2019-04-30info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentapplication/mswordapplication/pdfapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11187oai:ojs.www.actamedicaportuguesa.com:article/11187Acta Médica Portuguesa; Vol. 32 No. 4 (2019): April; 289-294Acta Médica Portuguesa; Vol. 32 N.º 4 (2019): Abril; 289-2941646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11187https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11187/5662https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11187/10702https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11187/10703https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11187/10899https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11187/10953https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11187/10962Direitos de Autor (c) 2019 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessAires, AnaBarros, ArianaMachado, CéliaFitas, DiogoCação, GonçaloPedrosa, RuiCerqueira, JoãoPerdigão, SandraSilva, Ana Martins daVale, JoséSá, Maria JoséAndrade, Carlos2022-12-20T11:06:12Zoai:ojs.www.actamedicaportuguesa.com:article/11187Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:20:00.787859Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Diagnostic Delay of Multiple Sclerosis in a Portuguese Population Atraso no Diagnóstico de Esclerose Múltipla numa População Portuguesa |
title |
Diagnostic Delay of Multiple Sclerosis in a Portuguese Population |
spellingShingle |
Diagnostic Delay of Multiple Sclerosis in a Portuguese Population Aires, Ana Age at Onset Delayed Diagnosis Multiple Sclerosis Referral and Consultation Diagnóstico Tardio Encaminhamento e Consulta Esclerose Múltipla Idade de Início |
title_short |
Diagnostic Delay of Multiple Sclerosis in a Portuguese Population |
title_full |
Diagnostic Delay of Multiple Sclerosis in a Portuguese Population |
title_fullStr |
Diagnostic Delay of Multiple Sclerosis in a Portuguese Population |
title_full_unstemmed |
Diagnostic Delay of Multiple Sclerosis in a Portuguese Population |
title_sort |
Diagnostic Delay of Multiple Sclerosis in a Portuguese Population |
author |
Aires, Ana |
author_facet |
Aires, Ana Barros, Ariana Machado, Célia Fitas, Diogo Cação, Gonçalo Pedrosa, Rui Cerqueira, João Perdigão, Sandra Silva, Ana Martins da Vale, José Sá, Maria José Andrade, Carlos |
author_role |
author |
author2 |
Barros, Ariana Machado, Célia Fitas, Diogo Cação, Gonçalo Pedrosa, Rui Cerqueira, João Perdigão, Sandra Silva, Ana Martins da Vale, José Sá, Maria José Andrade, Carlos |
author2_role |
author author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Aires, Ana Barros, Ariana Machado, Célia Fitas, Diogo Cação, Gonçalo Pedrosa, Rui Cerqueira, João Perdigão, Sandra Silva, Ana Martins da Vale, José Sá, Maria José Andrade, Carlos |
dc.subject.por.fl_str_mv |
Age at Onset Delayed Diagnosis Multiple Sclerosis Referral and Consultation Diagnóstico Tardio Encaminhamento e Consulta Esclerose Múltipla Idade de Início |
topic |
Age at Onset Delayed Diagnosis Multiple Sclerosis Referral and Consultation Diagnóstico Tardio Encaminhamento e Consulta Esclerose Múltipla Idade de Início |
description |
Introduction: Multiple sclerosis is a chronic inflammatory disease, in which a diagnostic delay could reduce the available therapeutic options. Therefore, it is important to monitor the time to diagnosis and understand factors that may potentially reduce it. The objective of this study was to determine the time between the first symptoms and the diagnosis of multiple sclerosis and which factors may contribute to a diagnostic delay.Material and Methods: Cross-sectional multicenter study, with retrospective data analysis, conducted in five tertiary Portuguese hospitals. Patients were consecutively selected from each local multiple sclerosis patients´ database. Sociodemographic and initial clinical data were collected through a questionnaire. Date of final diagnosis and multiple sclerosis classification was obtained from clinical files.Results: A total of 285 patients were included with mean age at diagnosis of 36 years. The median time between first clinical manifestation and multiple sclerosis diagnosis was nine months (IQR 2 - 38). Diagnostic delay was associated with an older age (p < 0.001; r = 0.35), motor deficit at onset [26.5 months (IQR 4.5 - 56.5); p = 0.0005], higher number of relapses before diagnosis (p < 0.001; r = 0,626), first observation by other medical specialty [11 months (IQR 2 - 48); p < 0.001], prior alternative diagnosis [20 months (IQR 4 - 67.5); p < 0.001] and primary progressive subtype [37 months (IQR 25 - 64.5); p < 0.001]. The most significant delay occurred between the initial symptom and neurological observation.Discussion: A significant delay occurred between initial symptoms and the diagnosis of multiple sclerosis, reflecting the need toincrease awareness of this entity and its diverse symptom presentation. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-04-30 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11187 oai:ojs.www.actamedicaportuguesa.com:article/11187 |
url |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11187 |
identifier_str_mv |
oai:ojs.www.actamedicaportuguesa.com:article/11187 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11187 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11187/5662 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11187/10702 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11187/10703 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11187/10899 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11187/10953 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11187/10962 |
dc.rights.driver.fl_str_mv |
Direitos de Autor (c) 2019 Acta Médica Portuguesa info:eu-repo/semantics/openAccess |
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Direitos de Autor (c) 2019 Acta Médica Portuguesa |
eu_rights_str_mv |
openAccess |
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application/pdf application/pdf application/vnd.openxmlformats-officedocument.wordprocessingml.document application/msword application/pdf application/pdf |
dc.publisher.none.fl_str_mv |
Ordem dos Médicos |
publisher.none.fl_str_mv |
Ordem dos Médicos |
dc.source.none.fl_str_mv |
Acta Médica Portuguesa; Vol. 32 No. 4 (2019): April; 289-294 Acta Médica Portuguesa; Vol. 32 N.º 4 (2019): Abril; 289-294 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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