Retraso diagnóstico de esclerosis múltiple y sus factores asociados en los pacientes del Hospital Córdoba. Desafíos en la identificación precoz de la enfermedad en un centro de referencia

Abstract

Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system and the leading cause of non-traumatic neurological disability in young adults. An early diagnosis is crucial for initiating disease-modifying treatments and preventing the progression of disability. However, multiple factors can delay diagnosis and treatment initiation. The objective of this study was to identify these factors and their impact on time to diagnosis and treatment in a cohort of patients at Hospital Córdoba. The researchers conducted a cross-sectional observational study of 153 adult patients diagnosed with multiple sclerosis according to the 2017 McDonald criteria. Their clinical and demographic data were collected and analyzed using logistic regression to determine the factors associated with an early versus late diagnosis or early versus late treatment initiation. The median times to diagnosis and treatment initiation were 95 and 184 days, respectively. Factors such as clinical onset with optic neuritis, diplopia, or motor symptoms were associated with an early diagnosis. In contrast, lack of health insurance, delays in test authorization, and delays in medication dispensing were relevant factors in late treatment initiation, though not statistically significant. Delaying consultation with a specialist was a significant predictor of late treatment initiation. This study highlights the frequency of late diagnosis of multiple sclerosis at Hospital Córdoba, which impacts the progression of disability. Specific clinical factors can favor early diagnosis, while barriers to access and delays in care can complicate the timely initiation of treatment. Improving health education and access to diagnostic resources for vulnerable populations could reduce these delays and improve patient outcomes.