Baseline Characteristics of the Primary Care Cohort and the Referred Cohort
| Characteristic | Main Analysis | Referred Cohort by Origin | Referred Cohort by Referral | |||
|---|---|---|---|---|---|---|
| Primary Care Cohort (n = 114) | Referred Cohort (n = 90) | Primary Care Patients With Red Flag(s) (n = 24)a | Specialist Care Patients (n = 66) | Referred by Primary Care Physician (n = 65)b | Referred by General Pediatrician (n = 25) | |
| Male, No. (%) | 38 (33) | 37 (41) | 8 (33) | 29 (44) | 29 (45) | 8 (32) |
| Age, median (IQR), y | 9 (6–12) | 11 (7–15) | 9 (6–14) | 12 (7–15) | 10 (7–14) | 14 (10–15.5) |
| Presenting symptoms | ||||||
| Recurrent abdominal pain, No. (%) | 88 (77) | 58 (64) | 16 (67) | 42 (64) | 38 (59) | 20 (80) |
| Chronic diarrhea, No. (%) | 74 (65) | 62 (69) | 17 (71) | 45 (68) | 40 (62) | 22 (88) |
| Involuntary weight loss, No. (%) | 5 (4)c | 23 (26) | 1 (4) | 22 (33) | 10 (15) | 13 (52) |
| Rectal blood loss, No. (%) | 7 (6) | 27 (30) | 6 (25) | 21 (32) | 13 (20) | 14 (56) |
| Family history of IBD, No. (%) | 5 (4) | 11 (12) | 5 (21) | 6 (9) | 9 (14)d | 2 (8) |
| Growth failure, No. (%) | 4 (3) | 6 (7) | 3 (13) | 3 (5) | 6 (9) | 0 (0) |
| Extraintestinal symptoms, No. (%) | 0 (0) | 13 (14) | 0 (0) | 13 (20) | 4 (6) | 9 (36) |
| Perianal lesions, No. (%) | 7 (6) | 13 (14) | 7 (29) | 6 (9) | 9 (14) | 4 (17)e |
| Positive blood markers, n/N (%) | ||||||
| Hemoglobinf | 1/111 (1) | 11/86 (13) | 1/24 (4) | 10/62 (16) | 5/61 (8) | 6/25 (24) |
| CRP (>10 mg/L) | 2/110 (2) | 10/76 (13) | 2/24 (8) | 8/52 (15) | 5/56 (9) | 5/20 (25) |
| ESR (>20 mm/h) | 5/111 (5) | 16/83 (19) | 5/24 (21) | 11/59 (19) | 8/59 (14) | 8/24 (33) |
| Platelet count (>450 × 109/L) | 4/111 (4) | 7/86 (8) | 2/24 (8) | 5/62 (8) | 4/61 (7) | 3/25 (12) |
| Anti–tissue transglutaminase,g n/N | 0/100 | 0/72 | 0/21 | 0/51 | 0/55 | 0/18 |
| ≥1 Red flag,h No. (%) | 29 (25) | 68 (76) | 24 (100) | 44 (67) | 43 (66) | 25 (100) |
| Endoscopy, No. (%) | 2 (2) | 29 (32) | 2 (8) | 27 (41) | 9 (14) | 20 (80) |
| IBD, No. (%) | 0 (0) | 17 (19) | 0 (0) | 17 (26) | 5/64 (8) | 12 (48) |
CRP = C-reactive protein; ESR = erythrocyte sedimentation rate; IBD = inflammatory bowel disease; IQR = interquartile range.
↵a Five children with red flags were ultimately not seen by a pediatric gastroenterologist: 3 declined because of reduced symptoms, 2 were lost to follow-up.
↵b Including primary care physicians who did not participate in this study.
↵c Three children had no further weight loss after 3 weeks.
↵d Denominator is 64.
↵e Denominator is 24.
↵f Age and sex specific: aged 4–12 years <7.1 mmol/L; aged 12–18 years: boys <8.1 mmol/L, girls <7.4 mmol/L.
↵g Twenty-five children had IgA deficiency.
↵h Growth failure, involuntary weight loss, rectal blood loss, family history of IBD, extraintestinal symptoms, perianal lesions, positive blood markers (hemoglobin, CRP, ESR, platelet count).