2026-06-14T03:30:03Zhttps://repisalud.isciii.es/rest/oai/requestoai:repisalud.isciii.es:20.500.12105/70332024-09-27T16:19:50Zcom_20.500.12105_2052com_20.500.12105_2051col_20.500.12105_19608
Repisalud
author
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
funder
Unión Europea. Comisión Europea
2019-01-30T18:16:11Z
2019-01-30T18:16:11Z
2013-05-23
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
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.
eng
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
research article
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LateInLifeSurgery_2013.pdf.txt