Gender-related diagnostic delay in bronchiectasis

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Background: Bronchiectasis is a chronic respiratory condition often underestimated by healthcare workers. Diagnostic delays are frequently described worldwide. Aim of the study is to evaluate if the diagnostic process is affected by gender differences, as well as to assess predictors of diagnostic delays. Methods: An Italian observational study carried out in seven hospitals from November 2022 to May 2023 retrospectively selected adults with a clinical and radiological diagnosis of bronchiectasis. The diagnostic delay was defined as the period between the onset of symptoms and the diagnosis. A linear regression analysis was performed to assess the predictors of the diagnostic delay. Results: 232 (mean±SD age: 60±14 years; 72% female) patients were enrolled: 68.5% showed a delay >365 days. The median (IQR) diagnostic delay was 1,316 (243.5-5,697.5) days, with no gender-related differences. However, statistically significant differences of mean FVC% were found, with males showing lower levels (84.2%±24.6% VS. 96.5%±23.9%) and higher prevalence of CPAP/NIV usage (13% VS. 2%). Univariable linear regression showed that age, FVC%, and being a worker were associated to diagnostic delay. Conclusion: Most Italian patients had a diagnosis delay >1 year. Although clinical and social factors were associated with a diagnostic delay, gender was not proved as a significant predictor in Italy. Future research is needed to better understand gender dynamics in bronchiectasis patients.

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