Diagnostic delay among ALS patients: Egyptian study

Abstract

Introduction: In the current study, we are going to look at different factors responsible for the diagnostic delay of ALS patients among the sample of Egyptian patients. Method/patients: This is a cohort study. ALS patients were recruited from December 2018 to January 2020 from the ALS clinic at the international medical center (IMC) (Cairo, Egypt). We analyzed the site of onset, the time from symptom onset to diagnosis, age and sex differences among these ALS patients. Results: Thirty patients were included in the study. Seventy percent of the patients had limb onset ALS with a mean age of onset of 50 ± 12.1 vs 58.6 ± 2.1 years for the patients with bulbar onset (p = 0.02). Bulbar-onset patients were diagnosed earlier than limb onset patients (mean lag of 8.2 ± 2.57 months vs 22.95 ± 17.6 months respectively, p < 0.05). The average diagnosis time for women was slightly longer than that of men with a mean lag of 20.7 ± 21.1 vs. 17.6 ± 13.6 months, respectively, p > 0.05. Diagnostic delay and age at onset of symptoms were negatively correlated, however, this was not statistically significant. Discussion: To our knowledge, this the first population-based study from Egypt about predicting factors of diagnostic delay among Egyptian patients. Limb onset, female gender and young age are correlated with increased mean time to diagnosis. Statistically insignificant results could be attributed to a small sample. Larger population-based studies are needed from Egypt.