2026-06-14T03:32:34Zhttps://repisalud.isciii.es/rest/oai/request

oai:repisalud.isciii.es:20.500.12105/70332024-09-27T16:19:50Zcom_20.500.12105_2052com_20.500.12105_2051col_20.500.12105_19608

00925njm 22002777a 4500 dc Cruz, Mabel author Mahillo-Fernandez, Ignacio author Rábano, Alberto author Siden, Ake author Calero, Miguel author Laursen, Henning author Mølbak, Kåre author Almazan-Isla, Javier author Pedro-Cuesta, Jesus de author 2013-05-23 BACKGROUND: There is increasing epidemiological evidence of etiological links between general surgery and sporadic Creutzfeldt-Jakob disease (sCJD) with long incubation periods. The purpose of this study was to identify specific surgical procedures potentially associated with sCJD to be targeted for preventive presurgical-intervention guidance. RESULTS: We propose a three-step clinical guidance outline where surgical procedures associated with sCJD clinical onset - potentially more contaminant - are taken into account. Data on hospital discharges and surgical procedures were obtained from Danish and Swedish national in-patient hospital registries for 167 sCJD cases, onset 1987-2003, and for 835 matched and 2,224 unmatched population controls. Surgery was allocated to different life-time periods as previously reported, and frequencies were compared using logistic regression analysis. In the year preceding clinical onset, persons with sCJD underwent a statistically significant higher number of minor surgical interventions (OR (95% CI): 17.50 (3.64-84.24)), transluminal endoscopies (OR: 2.73 (1.01-7.37)) and gastrointestinal operations (OR: 3.51 (1.21-10.19)) compared to matched controls. Surgical discharges clustered towards clinical onset. These differences increased during the clinical period, with statistically significant higher frequencies for both endoscopies and minor surgery (OR: 13.91 (5.87-32.95), and for main surgical procedures (OR: 2.10 (1.00-4.39)), particularly gastrointestinal surgery (OR: 6.00 (1.83-19.66)), and surgery contacting skeletal muscle. Comparisons with unmatched controls yielded similar results for neurosurgery in the clinical period (OR: 19.40 (2.22-168.34)). CONCLUSIONS: These results suggest that some types of surgical procedures are associated with sCJD, after clinical onset or particularly just before onset. Selective planning of such surgery to minimize instrument/device contamination or quarantining might be feasible. Conditional to progress in sCJD etiological research, results are relevant for guidance development. Emerg Themes Epidemiol. 2013 May 23;10(1):5. 10.1186/1742-7622-10-5 1742-7622 Emerging themes in epidemiology 23701872 http://hdl.handle.net/20.500.12105/7033 Etiology Care Creutzfeldt-Jakob disease Epidemiology Guidelines Methods Public Health Safety Surgical procedures Late-in-life surgery associated with Creutzfeldt-Jakob disease: a methodological outline for evidence-based guidance