S1569 Impact of Delayed Diagnosis on Outcomes in Inflammatory Bowel Disease (IBD)

Introduction: Inflammatory Bowel Disease (IBD), encompassing Crohn’s disease (CD) and ulcerative colitis (UC), is a chronic inflammatory condition of the gastrointestinal tract. Delayed diagnosis is hypothesized to influence disease outcomes adversely, yet its impact remains underexplored, particularly in Saudi Arabia. This study investigates the association between diagnostic delay and clinical outcomes in IBD patients. Methods: This cross-sectional study utilized data from a prospectively maintained IBD registry at King Faisal Specialist Hospital and Research Centre from September 2023 to September 2024. Inclusion criteria comprised patients aged ≥14 years with a confirmed diagnosis of IBD. Diagnostic delay, defined as the time from symptom onset to diagnosis, was categorized as <1 year, 1–2 years, and >2 years. Clinical outcomes included the need for intestinal surgery, >2 advanced therapies, and a composite outcome (surgery, advanced therapies, or disease progression). Associations were assessed using Chi-squared and Fisher’s exact tests. Results: The cohort included 412 patients (mean age at diagnosis: 24 years; 55% male; 68% CD, 32% UC). The average diagnostic delay was 1.48 years, with 26% experiencing delays >2 years. Patients with longer delays were more likely to have CD (P = 0.049), older age at diagnosis (P = 0.017), and stricturing disease phenotype in CD (P = 0.013). Delayed diagnosis (>2 years) was associated with a higher prevalence of intestinal surgery (32% vs 23%; P = 0.045) and borderline significance for the composite outcome (P = 0.062). No significant associations were found between delay and use of >2 advanced therapies. Conclusion: Diagnostic delay in IBD is prevalent and associated with worse outcomes, particularly in patients with CD. Efforts to minimize diagnostic delays may improve clinical outcomes and reduce the need for surgical interventions. Further research with larger cohorts and longitudinal follow-up is warranted to elucidate these associations.