Factors impacting time to diagnosis in pediatric CNS tumors in Chinese children
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ORIGINAL ARTICLE
Factors impacting time to diagnosis in pediatric CNS tumors in Chinese children Pengwei Lu 1 & Raynald 2 & Wei Liu 1 & Jian Gong 1 & Tao Sun 1 & Chunde Li 1 & Lukman Ma’ruf 3 & Yanzhu Fan 1 & Ruifang Zhu 1 & Yongji Tian 1 Received: 27 February 2020 / Accepted: 28 October 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objective This study aimed to investigate the factors impacting time to diagnosis in pediatric central nervous system tumors. Methods A descriptive, cross-sectional design was used in this study. A self-developed questionnaire for health-seeking behavior and influencing factors was used in children with intracranial tumors. The factors related to time to diagnosis and the long-term prognosis of children were analyzed. Results A total of 433 families replied to the questionnaire. The median parental interval was 50 days (range 0 ~ 884), the median diagnostic interval was 97 days (range 4 ~ 1646), and the median prediagnostic symptomatic interval (PSI) was 123 days (range 8 ~ 1844). Higher education was associated with a shorter parental interval (mother: P = 0.048; father: P = 0.035). The diagnostic interval was shortened in patients with dizziness (P = 0.022), abnormal eye movement (P = 0.034), or drowsiness (P = 0.021). A shorter PSI was observed in patients who presented with high intracranial pressure such as headache (P = 0.016), dizziness (P = 0.009), or drowsiness (P = 0.023) and those who went to a higher-level health institution or patients who went to neurology or neurosurgery department as the first medical consultation. No statistically significant difference was found in the interval time (parental interval, diagnostic interval, and PSI) regarding patients’ outcomes. Conclusion Different time intervals showed different factors influencing the long delay in diagnosing central nervous system tumors, highlighting the need for increased awareness to improve the treatment efficacy. Keywords Children . Delay diagnosis . Initial symptom . Intracranial tumor
Abbreviations CNS Central nervous system GOS Glasgow Outcome Scale PSI Prediagnostic symptomatic interval
Supplementary Information The online version contains supplementary material available at https://doi.org/10.1007/s00520-02005863-6. * Yongji Tian [email protected] 1
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
2
Neurointervention Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
3
Department of Neurosurgery, Central Army Hospital, Jakarta, Indonesia
Introduction Recent advances in neurosurgery, oncology, and radiology have led to an improvement in the 5-year overall survival rate to 65–70%, although many children still have varying degrees of sequelae [1, 2]. Previous studies on the prediagnostic symptomatic interval (PSI) in pediatric patients with central nervous system (CNS) tumors in different Western counties have shown a delay in diagnosing CNS tumors, compared with other pediatric malignancie
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