Affiliation:
1. Department of Internal Medicine Kettering Health Main Campus Kettering Ohio USA
2. Wright State University Boonshoft School of Medicine Dayton Ohio USA
3. Department of Medical Affairs Dayton Children's Hospital Dayton Ohio USA
4. Department of Gastroenterology Dayton Children's Hospital Dayton Ohio USA
Abstract
AbstractObjectivesThis study aims to characterize pediatric inflammatory bowel disease (IBD) patients who change diagnosis and describe the characteristics of that change.MethodsA retrospective study was conducted on pediatric IBD patients from the ImproveCareNow (ICN) multicenter international cohort from 2007 to January 2019. Primary outcome was change in diagnosis after the first four visits. Other variables included demographics, diagnostics, disease characteristics, and timing.Results6.1% of 18,055 patients aged 1–20 years changed diagnosis. Median time between the baseline visit and first diagnosis change was 0.9 years. Change in diagnosis occurred in 257/12,178 (2.1%) patients with Crohn's disease (CD), 347/4758 (7.3%) patients with ulcerative colitis (UC), and 495/1119 (44.2%) patients with IBD‐Unclassified (IBD‐U). In multivariable analysis, initial diagnosis of IBD‐U and longer follow‐up times were associated with greater odds of a diagnosis change.ConclusionIBD‐U initial diagnosis and longer follow‐up were associated with increased diagnosis change risk. The most common change was reclassification to CD. Disease activity, moderate malnutrition, and presence of EIMs were not associated with change in diagnosis.