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The Capital Region of Denmark - a part of Copenhagen University Hospital

Risk factors for diagnostic delay in idiopathic pulmonary fibrosis

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BACKGROUND: Surveys and retrospective studies of patients with idiopathic pulmonary fibrosis (IPF) have shown a significant diagnostic delay. However, the causes and risk factors for this delay are not known.

METHODS: Dates at six time points before the IPF diagnosis (onset of symptoms, first contact to a general practitioner, first hospital contact, referral to an interstitial lung disease (ILD) centre, first visit at an ILD centre, and final diagnosis) were recorded in a multicentre cohort of 204 incident IPF patients. Based on these dates, the delay was divided into specific patient-related and healthcare-related delays. Demographic and clinical data were used to determine risk factors for a prolonged delay, using multivariate negative binomial regression analysis.

RESULTS: The median diagnostic delay was 2.1 years (IQR: 0.9-5.0), mainly attributable to the patients, general practitioners and community hospitals. Male sex was a risk factor for patient delay (IRR: 3.84, 95% CI: 1.17-11.36, p = 0.006) and old age was a risk factor for healthcare delay (IRR: 1.03, 95% CI: 1.01-1.06, p = 0.004). The total delay was prolonged in previous users of inhalation therapy (IRR: 1.99, 95% CI: 1.40-2.88, p <  0.0001) but not in patients with airway obstruction. Misdiagnosis of respiratory symptoms was reported by 41% of all patients.

CONCLUSION: Despite increased awareness of IPF, the diagnostic delay is still 2.1 years. Male sex, older age and treatment attempts for alternative diagnoses are risk factors for a delayed diagnosis of IPF. Efforts to reduce the diagnostic delay should focus on these risk factors.

TRIAL REGISTRATION: This study was registered at (NCT02772549) on May 10, 2016.

Original languageEnglish
JournalRespiratory Research
Issue number1
Pages (from-to)103
Publication statusPublished - 24 May 2019

    Research areas

  • Aged, Aged, 80 and over, Cohort Studies, Delayed Diagnosis/trends, Denmark/epidemiology, Female, Humans, Idiopathic Pulmonary Fibrosis/diagnosis, Male, Prospective Studies, Risk Factors, Time-to-Treatment/trends

ID: 59435750