246P Factors affecting the diagnostic delay of myasthenia gravis.

Early detection and diagnosis of myasthenia gravis (MG) is important in order to quickly initiate treatment, which in turn can enhance the individual's quality of life and prognosis. This study aims to investigate the delay from onset of symptoms to the diagnosis of MG, and the variables that may affect the delay. By doing so, we aim to highlight the potential for improvement and increase awareness about the challenges in the diagnostic process of MG. We studied retrospective data from a cohort of 350 patients treated for MG at the Neuromuscular Unit, Rigshospitalet, Copenhagen, between 1980 and 2022. To identify potential factors, we examined the baseline characteristics and the factors involved in the diagnostic process. We classified individuals into two subgroups based on their time to diagnosis: early diagnosis and delayed diagnosis. Moreover, a separate analysis was conducted for the cases with an extremely delayed time to diagnosis exceeding the upper quartile range of 864 days (n=28). Finally, the change in time to diagnose over the last decades has been identified. The overall mean time to diagnosis was 331 days (range: 5-4492 days), with 64 days for the early group and 600 days for the delayed group. Patients who experienced a delayed diagnosis were significantly younger at onset (50.4 versus 55.4 years, p-value < 0.05), and had higher frequency of asymptomatic periods (47% vs 15%, p-value <0.001). We found a delayed referral to specialists, extended time spent at specialists, and delayed initiation of paraclinical diagnostic tests. Gender, type of onset symptom, final type of MG and socioeconomic status where not found to be factors affecting the time to diagnosis. A trend of decreasing time to diagnosis over the last decades was observed. In conclusion, early onset of symptoms and higher prevalence of asymptomatic periods may be risk factors for a delayed MG diagnosis. [ABSTRACT FROM AUTHOR]