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Table of Contents
Vol. 31, No. 4, 2008
Issue release date: November 2008
Section title: Original Paper
Free Access
Neuroepidemiology 2008;31:229–240

Surgery and Risk of Sporadic Creutzfeldt-Jakob Disease in Denmark and Sweden: Registry-Based Case-Control Studies

Mahillo-Fernandez I.a · de Pedro-Cuesta J.a · Bleda M.J.a · Cruz M.b · Mølbak K.c · Laursen H.d · Falkenhorst G.c · Martínez-Martín P.a · Siden Å.b
aDepartment of Applied Epidemiology, National Center for Epidemiology, and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Carlos III Institute of Health, Madrid, Spain; bDepartment of Clinical Neurosciences, Neurology Division, Karolinska Institutet, Stockholm, Sweden; cDepartment of Epidemiology, Statens Serum Institute, and dNeuropathology Laboratory, Rigshospitalet, Copenhagen, Denmark
email Corresponding Author

Jesús de Pedro Cuesta

Centro Nacional de Epidemiología, Instituto de Salud Carlos III

Calle Sinesio Delgado 6, Pabellón 12

ES–28029 Madrid (Spain)

Tel. +34 91 8222 650, Fax +34 91 3877 815, E-Mail jpedro@isciii.es

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Background: Epidemiologic evidence of surgical transmission of sporadic Creutzfeldt-Jakob disease (sCJD) remains controversial. Methods: From Danish and Swedish registries we selected 167 definite and probable sCJD cases (with onset between 1987 and 2003) and 3,059 controls (835 age-, sex-, and residence-matched, and 2,224 unmatched). Independent of case/control status, surgical histories were obtained from National Hospital Discharge Registries. Surgical procedures were categorized by body system group and lag time to onset of sCJD. Exposure frequencies were compared using logistic regression. Results: A history of any major surgery, conducted ≧20 years before sCJD onset, was more common in cases than both matched (OR = 2.44, 95% CI = 1.46–4.07) and unmatched controls (OR = 2.25, 95% CI = 1.48–3.44). This observation was corroborated by a linear increase in risk per surgical discharge (OR = 1.57, 95% CI = 1.13–2.18; OR = 1.50, 95% CI = 1.18–1.91). Surgery of various body systems, including peripheral vessels, digestive system and spleen, and female genital organs, was significantly associated with increased sCJD risk. Conclusions: A variety of major surgical procedures constitute a risk factor for sCJD following an incubation period of many years. A considerable number of sCJD cases may originate from health care-related accidental transmission.

© 2008 S. Karger AG, Basel

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: April 23, 2008
Accepted: July 31, 2008
Published online: October 09, 2008
Issue release date: November 2008

Number of Print Pages: 12
Number of Figures: 2
Number of Tables: 5

ISSN: 0251-5350 (Print)
eISSN: 1423-0208 (Online)

For additional information: http://www.karger.com/NED

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